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Gustav Smith, MD, PhD

Gustav Smith

Associate professor

Gustav Smith, MD, PhD

Echocardiographic right ventricular strain from multiple apical views is superior for assessment of right ventricular systolic function

Author

  • A. Werther Evaldsson
  • A. Ingvarsson
  • J. G. Smith
  • G. Rådegran
  • A. Roijer
  • J. Waktare
  • E. Ostenfeld
  • C. Meurling

Summary, in English

Background: Right ventricular (RV) systolic function is an important determinant of outcome in patients with pulmonary hypertension (PH). Conventional echocardiographic measures of RV are mainly based on longitudinal contractility. Recently, measurement of RV global longitudinal strain derived from multiple windows (RVGLS) has emerged as an option but has not been well evaluated. The aim of the present study was to evaluate which echocardiographic RV function parameter correlates best with RV ejection fraction derived from cardiac magnetic resonance imaging (RVEFCMR). Methods and results: Fifty-five patients evaluated for PH underwent RV assessment with echocardiography and CMR. Conventional echocardiographic parameters of RV function including tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (S′), RV fractional area change (RVFAC) and RV index of myocardial performance (RIMP). RVGLS was measured from three separate apical views using a 17-segment model and strain from the lateral free wall was calculated separately (RVfree). The study included 55 patients, whereas assessment of RVGLS could be obtained in 29 patients. The Pearson correlation coefficient with RVEFCMR was strong for RVGLS (r = 0·814, P<0·001) and RVfree (r = 0·778, P<0·001), modest for RVFAC (r = 0·681, P<0·001), TAPSE (r = 0·592, P<0·001) and RIMP (r=−0·521, P<0·01), and weak for S′ (r = 0·385, P<0·01). Conclusion: The echocardiographic RV measures, RVGLS and RVfree correlated well with RVEFCMR, whereas correlation with TAPSE, RIMP and S′ was unsatisfactory. Our findings suggest that RVGLS and RVfree are the preferred echocardiographic methods for clinical practice. RVfree is easiest to perform but RVGLS could provide incremental value in selected patients.

Department/s

  • Cardiology
  • Heart Failure and Mechanical Support
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • Molecular Epidemiology and Cardiology
  • Cardiopulmonary disease - information, support and reception
  • Lund Cardiac MR Group

Publishing year

2019

Language

English

Pages

168-176

Publication/Series

Clinical Physiology and Functional Imaging

Volume

39

Issue

2

Document type

Journal article

Publisher

John Wiley & Sons Inc.

Topic

  • Cardiac and Cardiovascular Systems
  • Radiology, Nuclear Medicine and Medical Imaging

Keywords

  • right ventricular bullseye plot
  • right ventricular ejection fraction
  • right ventricular global longitudinal strain
  • right ventricular systolic function
  • speckle tracking

Status

Published

Research group

  • Heart Failure and Mechanical Support
  • Molecular Epidemiology and Cardiology
  • Cardiopulmonary disease - information, support and reception
  • Lund Cardiac MR Group

ISBN/ISSN/Other

  • ISSN: 1475-0961