title: Right ventricular function quantification in Takotsubo cardiomyopathy using two-dimensional strain echocardiography.
abstract: OBJECTIVE
  This study sought to characterize global and regional right ventricular (RV) myocardial function in patients with Takotsubo cardiomyopathy (TC) using 2D strain imaging.
  
  
  METHODS
  We compared various parameters of RV and left ventricular (LV) systolic function between 2 groups of consecutive patients with TC at initial presentation and upon follow-up. Group 1 had RV involvement and group 2 did not have RV involvement.
  
  
  RESULTS
  At initial presentation, RV peak systolic longitudinal strain (RVPSS) and RV fractional area change (RVFAC) were significantly lower in group 1 (-13.2±8.6% vs. -21.8±5.4%, p = 0.001; 30.7±9.3% vs. 43.5±6.3%, p = 0.001) and improved significantly upon follow-up. Tricuspid annular plane systolic excursion (TAPSE) did not differ significantly at initial presentation between both groups (14.8±4.1 mm vs. 17.9±3.5 mm, p = 0.050). Differences in regional systolic RV strain were only observed in the mid and apical segments. LV ejection fraction (LVEF) and LV global strain were significantly lower in group 1 (36±8% vs. 46±10%, p = 0.006 and -5.5±4.8% vs. -10.2±6.2%, p = 0.040) at initial presentation. None of the parameters were significantly different between the 2 groups upon follow-up. A RVPSS cut-off value of >-19.1% had a sensitivity of 85% and a specificity of 71% to discriminate between the 2 groups.
  
  
  CONCLUSIONS
  In TC, RVFAC, RVPSS, LVEF and LV global strain differed significantly between patients with and without RV dysfunction, whereas TAPSE did not. 2 D strain imaging was feasible for the assessment of RV dysfunction in TC and could discriminate between patients with and without RV involvement in a clinically meaningful way.
authors.affiliation: First Medical Department, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Heggemann
authors.affiliation: Department of Cardiology, Center of Cardiovascular Medicine, Bad Neustadt, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Hamm
authors.affiliation: Department of Biometrics and Statistics, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Brade
authors.affiliation: First Medical Department, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Streitner
authors.affiliation: First Medical Department, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Doesch
authors.affiliation: First Medical Department, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Theano
authors.initials: T
authors.lastname: Papavassiliu
authors.affiliation: First Medical Department, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Borggrefe
authors.affiliation: First Medical Department, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Dariusch
authors.initials: D
authors.lastname: Haghi
mesh_terms: D000368:Aged; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D013599:Systole; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016278:Ventricular Function, Right / Q000502:physiology*
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