Timing and Magnitude of Regional Right Ventricular Function: A Speckle Tracking-Derived Strain Study of Normal Subjects and Patients with Right Ventricular Dysfunction

Meris, Alessandra; Faletra, Francesco F.; Conca, Cristina; Klersy, Catherine; Regoli, François; Klimusina, Julia; Penco, María; Pasotti, Elena; Pedrazzini, Giovanni; Moccetti, Tiziano; Auricchio, Angelo

doi:10.1016/j.echo.2010.05.009

Cited by 183 publications

(162 citation statements)

References 35 publications

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“…Conversely, all the other approaches (M1, M3, and M4; Figure 3) to obtain free wall 3-segment RVLS average yielded similar values, irrespective of the use of a 3-segment or a 6-segment ROI or of the strain averaging method (M3: manually averaging of free wall segments by the operator from nonsimultaneous segmental values versus M4: measured as the systolic peak of the average strain curve; Figure 2). Because in healthy subjects the segmental peaks are almost simultaneous, 22 our pilot study was useful to confirm the assumption that M3 and M4 provide practically similar measurements. As both M1 and M4 were used interchangeably in previous articles, we aimed to compare them in the entire population not only in terms of reference values but also as feasibility and reproducibility and consequently to identify which one is more suitable for the routine clinical use.…”

Section: Pilot Studymentioning

confidence: 53%

Sex- and Method-Specific Reference Values for Right Ventricular Strain by 2-Dimensional Speckle-Tracking Echocardiography

Muraru

Onciul

Peluso

et al. 2016

Circ: Cardiovascular Imaging

193

129

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Accordingly, in this prospective study, we aimed to (1) assess the presence and extent of measurement variability in relation to the various methods and definitions of RVLS, Background-Despite the fact that assessment of right ventricular longitudinal strain (RVLS) carries important implications for patient diagnosis, prognosis, and treatment, its implementation in clinical settings has been hampered by the limited reference values and the lack of uniformity in software, method, and definition used for measuring RVLS. Accordingly, this study was designed to establish (1) the reference values for RVLS by 2-dimensional speckle-tracking echocardiography; and (2) their relationship with demographic, hemodynamic, and cardiac factors. Methods and Results-In 276 healthy volunteers (55% women; age, 18-76 years), free wall and septum RVLS (6 segments) and free wall RVLS (3 segments) using both 6-and 3-segment regions of interest were obtained. Feasibility of 6-segment RVLS was 92%. Free wall RVLS from 3-versus 6-segment regions of interest had similar values, yet 6-segment region of interest was more feasible (86% versus 73%; P<0.001) and reproducible. Reference values (lower limits of normality) were as follows: 6-segment RVLS, −24.7±2.6% (−20.0%) for men and −26.7±3.1% (−20.3%) for women; 3-segment RVLS, −29.3±3.4% (−22.5%) for men and −31.6±4.0% (−23.3%) for women (P<0.001). Free wall RVLS was 5±2 strain units (%) larger in magnitude than 6-segment RVLS, 10±4% larger than septal RVLS, and 2±4% larger in women than in men (P<0.001). At multivariable analysis, age, sex, pulmonary systolic pressure, right atrial minimal volume, as well as right atrial and left ventricular longitudinal strain resulted as correlates of RVLS values. Conclusions-This is the largest study providing sex-and method-specific reference values for RVLS. Our data may foster the implementation of 2-dimensional speckle-tracking echocardiography-derived RV analysis in clinical practice.(Circ Cardiovasc Imaging. 2016;9:e003866.

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Section: Pilot Studymentioning

confidence: 53%

Sex- and Method-Specific Reference Values for Right Ventricular Strain by 2-Dimensional Speckle-Tracking Echocardiography

Muraru

Onciul

Peluso

et al. 2016

Circ: Cardiovascular Imaging

193

129

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“…Good correlations were obtained comparing TAPSE with RVEF, [16][17][18][19][20] and better correlations were obtained comparing TAPSE with RV fractional area of change 6,12 and global RV strain. 21 Correlations were more modest when compared with RVEF using magnetic resonance imaging. 16 Theoretically, RV annular displacement should be related to SV.…”

Section: Discussionmentioning

confidence: 97%

Evaluation of TAPSE as a measure of right ventricular output

Tousignant

Kim

Papa

et al. 2012

Can J Anesth/J Can Anesth

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Purpose This study was designed to show the relationship between tricuspid annular plane systolic excursion (TAPSE) and stroke volume (SV) by thermodilution using three different methods and also to assess whether TAPSE can track hemodynamic changes associated with volume loading and ephedrine administration. Methods This was an observational study in 61 elective patients with a pulmonary artery catheter who were undergoing coronary artery bypass graft surgery in a cardiac surgical centre. We measured TAPSE by three methods using transesophageal echocardiography: M mode, speckle tracking at the lateral wall, and tissue tracking at the inferior wall. There were two interventions: leg raising (volume recruitment) or administration of ephedrine 5 mg iv. Echo and hemodynamic measurements were performed before and after each intervention.Results Eleven patients were excluded due to poor imaging. There were 26 patients in the leg raising group and 24 patients in the ephedrine group. The correlation coefficient between stroke volume (SV) and TAPSE by M mode, speckle tracking, and tissue tracking was 0.48, 0.44, and 0.09, respectively. There was a significant increase in SV following each intervention; however, the changes in TAPSE by any method and velocity were not large enough to reach statistical significance. Conclusion Tricuspid annular plane systolic excursion by M mode and by speckle tracking correlates modestly with SV. There was no correlation between TAPSE and SV by tissue tracking at the inferior wall of the right ventricle. Tricuspid annular plane systolic excursion by M mode and by speckle tracking does not track changes in SV following either volume loading or ephedrine administration. RésuméObjectif Cette e´tude a e´te´conçue pour montrer le rapport entre le de´placement systolique du plan de l'anneau tricuspidien (TAPSE) avec le volume d'e´jection systolique (SV) par thermodilution en utilisant trois me´thodes diffe´rentes et aussi pour de´terminer si le TAPSE peut suivre les modifications he´modynamiques associe´es a`une charge volumique et a`une administration d'e´phe´drine. Méthodes Il s'agit d'une e´tude observationnelle mene´e chez 61 patients se´lectionne´s porteurs d'un cathe´ter de l'arte`re pulmonaire qui devaient subir un pontage coronarien dans un centre de chirurgie cardiaque. Nous avons mesure´le TAPSE par trois me´thodes diffe´rentes al 'aide d'une e´chocardiographie transoesophagienne: mode M;suivi de granularite´s (speckle tracking) sur la paroi late´rale; et suivi de tissu (tissue tracking) sur la paroi infe´rieure. Il y a eu deux interventions: jambes releve´es

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“…The post-systolic strain index (PSI) was calculated from the following formula: PSI = (peak strain -PSS)/peak strain. (Meris et al , 2010, Teske, De Boeck, 2007 Both PSS and PSI at the basal and mid-RV free wall were averaged.…”

Section: Echocardiographymentioning

confidence: 99%

Longitudinal strain of right ventricular free wall by 2-dimensional speckle-tracking echocardiography is useful for detecting pulmonary hypertension

et al. 2014

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Aims: Echocardiography is widely used for screening of pulmonary hypertension (PH). More recently developed two-dimensional speckle-tracking echocardiography (2D-STE) can assess regional deformation of the myocardium and is useful for detecting left ventricular dysfunction. However, its usefulness to assess right ventricular (RV) dysfunction is not clear. Therefore, the aim of this study was to investigate the ability of peak systolic strain (PSS) and post-systolic strain index (PSI) at the RV free wall determined by 2D-STE to detect PH.Main methods: Thirty-six images (27 images from PH patients, nine from patients with connective tissue disease without PH) obtained by 2D-STE were analysed. We investigated the relationship between RV hemodynamics measured by right heart catheterization and PSS, PSI and other echocardiographic parameters reflecting RV overload including RV end-diastolic diameter (RVDd) and tricuspid valve regurgitant pressure gradient (TRPG).Key findings: PSS, PSI, RVDd and TRPG were all correlated with mean pulmonary arterial pressure (MPAP) and pulmonary vascular resistance (PVR). Furthermore, when PSS and MPAP were measured twice, the change in PSS was correlated with the change in MPAP (r=0.633, p=0.037). Multivariate logistic regression analysis identified PSS as the only independent factor associated with MPAP≥35 mmHg [odds ratio (OR), 1.616; 95% confidence interval (CI) 1.017-2.567; p=0.042] and PVR≥400 dyne·sec·cm -5 (OR, 1.804; 95% CI 1.131-2.877; p=0.013). Furthermore, the optimal PSS cut-off value to detect an elevated MPAP and PVR was -20.75%, based on receiver operating characteristic curve analysis.Significance: PSS of the RV free wall might serve as a useful non-invasive 2 indicator of PH.

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Timing and Magnitude of Regional Right Ventricular Function: A Speckle Tracking-Derived Strain Study of Normal Subjects and Patients with Right Ventricular Dysfunction

Cited by 183 publications

References 35 publications

Sex- and Method-Specific Reference Values for Right Ventricular Strain by 2-Dimensional Speckle-Tracking Echocardiography

Sex- and Method-Specific Reference Values for Right Ventricular Strain by 2-Dimensional Speckle-Tracking Echocardiography

Evaluation of TAPSE as a measure of right ventricular output

Longitudinal strain of right ventricular free wall by 2-dimensional speckle-tracking echocardiography is useful for detecting pulmonary hypertension

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