title: Right ventricular myocardial deformation patterns in children with congenital heart disease associated with right ventricular pressure overload.
abstract: OBJECTIVE
  Longitudinal wall motion of the right ventricle (RV) has been thoroughly studied in patients with RV dysfunction. However, circumferential strain of the RV free wall has yet to be investigated. Therefore, this study was conducted to assess the utility of RV free wall circumferential strain.
  
  
  RESULTS
  Strain profile curves were obtained using speckle tracking echocardiography from the subcostal left ventricular (LV) short-axis view in 30 normal children (normal group) and 25 patients with RV pressure overload (RVO group). The time-strain curves of three individual segmental (anterior, lateral, and inferior segments) and global circumferential deformations were evaluated. RV ejection fraction (RVEF), RV systolic pressure (RVSP), and RV fractional area change obtained in the four-chamber view and LV short-axis view [RVFAC (4CH) and RVFAC (SAX), respectively] were measured, and their relationships with RV free wall deformation were assessed. In the normal group, circumferential strain was significantly lower in the anterior segment than in the other segments. The inferior segment had a significantly larger strain than the other segments in the RVO group. Circumferential strain was predominant over longitudinal RV free wall strain in the RVO group (-18.4 ± 3.9 vs. -14.2 ± 3.8%, respectively; P < 0.005), whereas no significant difference between them was observed in the normal group (-23.0 ± 3.9 vs. -22.4 ± 4.7%, respectively). Global circumferential strain had a significantly higher correlation with RVFAC (4CH), RVFAC (SAX), RVEF, and RVSP than global longitudinal strain (P < 0.05 for all).
  
  
  CONCLUSIONS
  RV free wall circumferential strain provides better information about RV function than longitudinal strain in children with RVO.
authors.affiliation: Department of Pediatrics, University of Tokushima, Kuramoto-cho-3, Tokushima 770-8503, Japan hayabuchi@tokushima-u.ac.jp.
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Hayabuchi
authors.affiliation: Department of Pediatrics, University of Tokushima, Kuramoto-cho-3, Tokushima 770-8503, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Sakata
authors.affiliation: Department of Pediatrics, University of Tokushima, Kuramoto-cho-3, Tokushima 770-8503, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kagami
mesh_terms: D006328:Cardiac Catheterization; D016022:Case-Control Studies; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D017725:Ventricular Pressure / Q000502:physiology*
keywords: Children; Congenital heart disease; Right ventricle; Speckle tracking; Strain