title: Ventricular function and dyssynchrony quantified by speckle-tracking echocardiography in patients with acute and chronic right ventricular pressure overload.
abstract: BACKGROUND
  The aim of this study was to noninvasively investigate right ventricular and left ventricular (LV) adaptation to right ventricular pressure overload in patients with acute pulmonary thromboembolism (APTE) and chronic pulmonary artery hypertension (CPAH).
  
  
  METHODS
  Thirty-seven patients with APTE, 36 patients with CPAH, and 33 controls were retrospectively enrolled. Myocardial deformation and wall motion were analyzed using speckle-tracking strain and displacement imaging echocardiography in the right and left ventricles. The standard deviation of the heart rate-corrected intervals from QRS onset to peak systolic strain and peak systolic displacement (PSD) for the six segments was used to quantify right ventricular and LV mechanical dyssynchrony (peak systolic strain dyssynchrony and PSD dyssynchrony). The myocardial performance index in both ventricles was also evaluated.
  
  
  RESULTS
  The APTE and CPAH groups had reduced ventricular performance (LV myocardial performance index, 0.40 ± 0.10, 0.66 ± 0.18 [P < .05 vs controls], and 0.58 ± 0.19 [P < .05 vs controls] in the control, APTE, and CPAH groups, respectively) and large mechanical dyssynchrony (LV longitudinal PSD dyssynchrony, 58 ± 41 msec, 119 ± 49 msec [P < .05 vs controls], and 83 ± 37 msec [P < .05 vs controls and the APTE group] in the control, APTE, and CPAH groups, respectively) in both ventricles. Multiple regression analysis indicated that LV longitudinal PSD dyssynchrony in the APTE group and the LV eccentricity index in the CPAH group were independent determinants of LV myocardial performance index.
  
  
  CONCLUSIONS
  Pathophysiologic mechanisms that regulate ventricular performance vary depending on whether the ventricles are exposed to acute or chronic right ventricular pressure overload.
authors.affiliation: Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Ichikawa
authors.forename: Kaoru
authors.initials: K
authors.lastname: Dohi
authors.forename: Emiyo
authors.initials: E
authors.lastname: Sugiura
authors.forename: Tadafumi
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takamura
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Ogihara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Katsuya
authors.initials: K
authors.lastname: Onishi
authors.forename: Norikazu
authors.initials: N
authors.lastname: Yamada
authors.forename: Mashio
authors.initials: M
authors.lastname: Nakamura
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nobori
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
mesh_terms: D000208:Acute Disease; D000368:Aged; D002908:Chronic Disease; D004452:Echocardiography / Q000379:methods*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging*; D017725:Ventricular Pressure