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Comprehensive assessment of right ventricular function in patients with pulmonary hypertension with global longitudinal peak systolic strain derived from multiple right ventricular views.

Publication ,  Journal Article
Rajagopal, S; Forsha, DE; Risum, N; Hornik, CP; Poms, AD; Fortin, TA; Tapson, VF; Velazquez, EJ; Kisslo, J; Samad, Z
Published in: J Am Soc Echocardiogr
June 2014

BACKGROUND: Right ventricular (RV) function is a strong predictor of mortality in pulmonary hypertension (PH), but two-dimensional (2D) echocardiography-derived assessments of RV function that could aid in risk assessment and management of patients with PH are of limited utility. RV longitudinal peak systolic strain (RVLS) derived from 2D speckle-tracking echocardiography is a relatively novel method for quantifying RV function but typically is derived from a single apical four-chamber view of the right ventricle and may have inherent limitations. The objective of this study was to determine the utility of regional and global RVLS calculated from multiple views of the right ventricle to comprehensively assess RV function in a cohort of patients with PH. METHODS: Regional and global RVLS were obtained from multiple views of the right ventricle (centered on the right ventricle-focused apical position) in 40 patients with PH, defined as a mean pulmonary artery pressure ≥ 25 mm Hg, most of whom also had pulmonary capillary wedge pressures ≤ 15 mm Hg and were thus defined as having pulmonary arterial hypertension. This was compared with other 2D echocardiography-derived parameters of RV function and functional parameters. RESULTS: Global RVLS calculated from multiple views had a superior correlation with 6-min walk distance compared with other parameters of RV function, including tricuspid annular plane systolic excursion, RV myocardial performance index, and fractional area change. Although global RVLS calculated from multiple views displayed a similar correlation with 6-min walk distance as global RVLS calculated from a single four-chamber view, analysis of regional strains provided by multiple views identified distinct patterns of RV dysfunction, consisting of global, free wall, or septal dysfunction, that were associated with specific clinical characteristics. CONCLUSIONS: Global RVLS derived from multiple right ventricle-focused views yields a comprehensive quantitative assessment of regional and global RV function that correlates moderately with functional parameters and may be useful in the assessment of PH. Distinct patterns of regional RV dysfunction are associated with different clinical characteristics.

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Published In

J Am Soc Echocardiogr

DOI

EISSN

1097-6795

Publication Date

June 2014

Volume

27

Issue

6

Start / End Page

657 / 665.e3

Location

United States

Related Subject Headings

  • Ventricular Function, Right
  • Ventricular Dysfunction, Right
  • Middle Aged
  • Male
  • Hypertension, Pulmonary
  • Humans
  • Heart Ventricles
  • Female
  • Elasticity Imaging Techniques
  • Echocardiography
 

Citation

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Rajagopal, S., Forsha, D. E., Risum, N., Hornik, C. P., Poms, A. D., Fortin, T. A., … Samad, Z. (2014). 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(6), 657-665.e3. https://doi.org/10.1016/j.echo.2014.02.001
Rajagopal, Sudarshan, Daniel E. Forsha, Niels Risum, Christoph P. Hornik, Abby D. Poms, Terry A. Fortin, Victor F. Tapson, Eric J. Velazquez, Joseph Kisslo, and Zainab Samad. “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, no. 6 (June 2014): 657-665.e3. https://doi.org/10.1016/j.echo.2014.02.001.
Rajagopal, Sudarshan, et al. “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, vol. 27, no. 6, June 2014, pp. 657-665.e3. Pubmed, doi:10.1016/j.echo.2014.02.001.
Rajagopal S, Forsha DE, Risum N, Hornik CP, Poms AD, Fortin TA, Tapson VF, Velazquez EJ, Kisslo J, Samad Z. 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. 2014 Jun;27(6):657-665.e3.
Journal cover image

Published In

J Am Soc Echocardiogr

DOI

EISSN

1097-6795

Publication Date

June 2014

Volume

27

Issue

6

Start / End Page

657 / 665.e3

Location

United States

Related Subject Headings

  • Ventricular Function, Right
  • Ventricular Dysfunction, Right
  • Middle Aged
  • Male
  • Hypertension, Pulmonary
  • Humans
  • Heart Ventricles
  • Female
  • Elasticity Imaging Techniques
  • Echocardiography