Speckle Tracking Imaging in Patients with Pulmonary Hypertension
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
BACKGROUND: Right ventricular (RV) systolic dysfunction is a strong predictor of mortality in pulmonary hypertension (PH). The goal of this study was to investigate whether right atrium (RA) and RV myocardial strain related to PH using speckle tracking echocardiography provide a superior estimation of RV systolic function than 2-dimensional (2D)-echo. METHODS: This cross-sectional study analyzed 22 patients with a diagnosis of PH stratified by right heart catheterization, and they were compared to a control group of 22 age- and sex-matched healthy subjects. RESULTS: Global longitudinal peak systolic strain measured in the RV free wall from the apical 4 chamber view was −15% vs. −14.5% when measured from the subcostal view (p = 0.99). Mean longitudinal strain during reservoir phase, and longitudinal strain rate during atrial reservoir and passive conduit function was significantly impaired measured in the right atrial free wall in patients with PH. CONCLUSIONS: This study showed impaired LV contractility in patients with PH assessed by speckle tracking strain. RV free wall longitudinal strain does not correlate with any of the measurements of RV systolic function obtained by 2D echocardiography. A major strength of RV longitudinal strain is its ability to assess the RV function without the limitations of 2D parameters. The subcostal RV strain is a feasible and accurate alternative to conventional RV strain from the apical view in patients with poor acoustic apical 4-chamber windows. The RA strain and strain rates values may be a valuable additive to assess right-sided heart function.
Abstract
BACKGROUND: Right ventricular (RV) systolic dysfunction is a strong predictor of mortality in pulmonary hypertension (PH). The goal of this study was to investigate whether right atrium (RA) and RV myocardial strain related to PH using speckle tracking echocardiography provide a superior estimation of RV systolic function than 2-dimensional (2D)-echo. METHODS: This cross-sectional study analyzed 22 patients with a diagnosis of PH stratified by right heart catheterization, and they were compared to a control group of 22 age- and sex-matched healthy subjects. RESULTS: Global longitudinal peak systolic strain measured in the RV free wall from the apical 4 chamber view was −15% vs. −14.5% when measured from the subcostal view (p = 0.99). Mean longitudinal strain during reservoir phase, and longitudinal strain rate during atrial reservoir and passive conduit function was significantly impaired measured in the right atrial free wall in patients with PH. CONCLUSIONS: This study showed impaired LV contractility in patients with PH assessed by speckle tracking strain. RV free wall longitudinal strain does not correlate with any of the measurements of RV systolic function obtained by 2D echocardiography. A major strength of RV longitudinal strain is its ability to assess the RV function without the limitations of 2D parameters. The subcostal RV strain is a feasible and accurate alternative to conventional RV strain from the apical view in patients with poor acoustic apical 4-chamber windows. The RA strain and strain rates values may be a valuable additive to assess right-sided heart function.
참고문헌 (23)
- Sachdev A, "Right ventricular strain for prediction of survival in patients with pulmonary arterial hypertension", Chest, 139, pp.1299~1309 (2011)
- Sengupta PP, "RV form and function: a piston pump, vortex impeller, or hydraulicram?", JACC Cardiovasc Imaging, 6, pp.636~639 (2013)
- Rudski LG, "Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography", J Am Soc Echocardiogr, 23, pp.685~713 (2010)
- Hulshof HG, "5-Year prognostic value of the right ventricular strain-area loop in patients with pulmonary hypertension", Eur Heart J Cardiovasc Imaging, 22, pp.188~195 (2021)
- Hulshof HG, "Prognostic value of right ventricular longitudinal strain in patients with pulmonary hypertension : a systematic review and meta-analysis", Eur Heart J Cardiovasc Imaging, 20, pp.475~484 (2019)
- Marwick TH, "Myocardial strain measurement with 2-dimensional speckle-tracking echocardiography : definition of normal range", JACC Cardiovasc Imaging, 2, pp.80~84 (2009)
- Teske AJ, "Echocardiographic assessment of regional right ventricular function : a head-to-head comparison between 2-dimensional and tissue Doppler-derived strain analysis", J Am Soc Echocardiogr, 21, pp.275~283 (2008)
- Moceri P, "Three-dimensional right-ventricular regional deformation and survival in pulmonary hypertension", Eur Heart J Cardiovasc Imaging, 19, pp.450~458 (2018)
- Amundsen BH, "Noninvasive myocardial strain measurement by speckle tracking echocardiography : validation against sonomicrometry and tagged magnetic resonance imaging", J Am Coll Cardiol, 47, pp.789~793 (2006)
- Rehman MB, "Resting right ventricular function is associated with exercise performance in PAH, but not in CTEPH", Eur Heart J Cardiovasc Imaging, 19, pp.185~192 (2018)
- Fukuda Y, "Utility of right ventricular free wall speckle-tracking strain for evaluation of right ventricular performance in patients with pulmonary hypertension", J Am Soc Echocardiogr, 24, pp.1101~1108 (2011)
- Olschewski B, "ESC guidelines 2015 on pulmonary hypertension", Herz, 40, pp.1055~1060 (2015)
- Hoeper MM, "Definitions and diagnosis of pulmonary hypertension", J Am Coll Cardiol, 62, pp.D42~D50 (2013)
- Lang RM, "Recommendations for cardiac chamber quantification by echocardiography in adults : an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging", J Am Soc Echocardiogr, 28, pp.1~39 (2015)
- Badano LP, "Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI", ASE, Eur Heart J Cardiovasc Imaging, pp.2018, 19[DOI]
- Yingchoncharoen T, "Normal ranges of left ventricular strain : a meta-analysis", J Am Soc Echocardiogr, 26, pp.185~191 (2013)
- Carluccio E, "Prognostic value of right ventricular dysfunction in heart failure with reduced ejection fraction: superiority of longitudinal strain over tricuspid annular plane systolic excursion", Circ Cardiovasc Imaging, 11, pp.e006894~ (2018)
- Freed BH, "Right ventricular strain in pulmonary arterial hypertension : a 2D echocardiography and cardiac magnetic resonance study", Echocardiography, 32, pp.257~263 (2015)
- Rajdev S, "Tissue Doppler assessment of longitudinal right and left ventricular strain and strain rate in pulmonary artery hypertension", Echocardiography, 23, pp.872~879 (2006)
- Haeck ML, "Right ventricular longitudinal peak systolic strain measurements from the subcostal view in patients with suspected pulmonary hypertension : a feasibility study", J Am Soc Echocardiogr, 25, pp.674~681 (2012)
- Rajagopal S, "Comprehensive assessment of right ventricular function in patients with pulmonary hypertension with global longitudinal peak systolic strain derived from multiple right ventricular views", J Am Soc Echocardiogr, 27, pp.657~665 (2014)
- Willens HJ, "Effects of age and pulmonary arterial hypertension on the different phases of right atrial function", Int J Cardiovasc Imaging, 24, pp.703~710 (2008)
- Yamasaki Y, "Balloon pulmonary angioplasty improves right atrial reservoir and conduit functions in chronic thromboembolic pulmonary hypertension", Eur Heart J Cardiovasc Imaging, 21, pp.855~862 (2020)