Multiplane two-dimensional strain echocardiography for segmental analysis of right ventricular mechanics: new-RV study.
BACKGROUND
Recent studies showed the prognostic value of strain measurements of the free right ventricular (RV) wall. The aim of this study was to evaluate the feasibility and the diagnostic value of the assessment of longitudinal mechanics of all segments of the RV by multiplane, two-dimensional transthoracic (2D) strain echocardiography.


METHODS
A triplane apical visualization of the RV was attempted in each individual. RV systolic function was assessed with RV 2D strain, RV automated systolic index, real-time 3D echocardiography and RV parameters according to current guidelines.


RESULTS
The study population (n = 118) consisted of 81 consecutive patients with overt right ventricular systolic dysfunction due to different etiologies, 13 patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and 24 healthy controls. Triplane assessment of the RV was possible in all examinations. 2D strain of 18 segments could be obtained in 75 %, 9 segments of the RV free wall in 84 % and 3 segments in four-chamber view in 96 % of the examinations. Contrary to established RV parameters, RV 2D strain detected impaired RV function in all patient groups compared to the control group. In regard to global RV function, RV 2D strain by multiplane assessment was not superior to a monoplane approach. However, segmental strain analysis was able to define the presence of impaired RV function in ARVC patients which otherwise would have been missed by current standard parameters.


CONCLUSIONS
Regional RV mechanics were reliably assessed by RV 2D strain in a multiplane apical chamber view mode.
Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany, sebastian.greiner@med.uni-heidelberg.de.
Sebastian
S
Greiner
Melissa
M
Heimisch
Matthias
M
Aurich
Jan-Alexander
JA
Heß
Hugo A
HA
Katus
Derliz
D
Mereles
D000328:Adult; D004452:Echocardiography / Q000379:methods*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013314:Stress, Mechanical; D013318:Stroke Volume; D013718:Tensile Strength; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology*