Global and Regional Right Ventricular Function Assessed by Novel Three-Dimensional Speckle-Tracking Echocardiography

Tomoko Ishizu; Yoshihiro Seo; Akiko Atsumi; Yumiko Oishi Tanaka; Masayoshi Yamamoto; Tomoko Machino-Ohtsuka; Hitoshi Horigome; Kazutaka Aonuma; Yasushi Kawakami

doi:10.1016/j.echo.2017.08.007

Global and Regional Right Ventricular Function Assessed by Novel Three-Dimensional Speckle-Tracking Echocardiography

J Am Soc Echocardiogr. 2017 Dec;30(12):1203-1213. doi: 10.1016/j.echo.2017.08.007. Epub 2017 Nov 1.

Authors

Tomoko Ishizu¹, Yoshihiro Seo², Akiko Atsumi³, Yumiko Oishi Tanaka⁴, Masayoshi Yamamoto³, Tomoko Machino-Ohtsuka³, Hitoshi Horigome⁵, Kazutaka Aonuma³, Yasushi Kawakami¹

Affiliations

¹ Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
² Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. Electronic address: yo-seo@md.tsukuba.ac.jp.
³ Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
⁴ Department of Radiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
⁵ Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.

PMID: 29079046
DOI: 10.1016/j.echo.2017.08.007

Abstract

Background: Accurate assessment of global and regional right ventricular (RV) systolic function is challenging. The aims of this study were to confirm the reliability and feasibility of a three-dimensional (3D) speckle-tracking echocardiography (STE) system, using comparison with cardiac magnetic resonance imaging (CMR), and to assess the contribution of regional RV function to global function.

Methods: In a retrospective, cross-sectional study setting, RV volumetric data were studied in 106 patients who were referred for both CMR and 3D echocardiography within 1 month. Three-dimensional STE-derived area strain, longitudinal strain, and circumferential strain were assessed as global, inlet, outflow, apical, and septal segments.

Results: Seventy-five patients (70%) had adequate 3D echocardiographic data. RV measurements derived from 3D STE and CMR were closely related (RV end-diastolic volume, R² = 0.84; RV end-systolic volume, R² = 0.83; RV ejection fraction [RVEF], R² = 0.70; P < .001 for all). RVEF and RV end-diastolic volume from 3D STE were slightly but significantly smaller than CMR values (mean differences, -2% and -10 mL for RVEF and RV end-diastolic volume, respectively). Among conventional echocardiographic parameters for RV function (tricuspid annular plane systolic excursion, fractional area change, S' of the tricuspid annulus, RV free wall two-dimensional longitudinal strain), only fractional area change was significantly related to RVEF (r = 0.34, P = .003). Among segmental 3D strain variables, inlet area strain (r = -0.56, P < .001) and outflow circumferential strain (r = -0.42, P < .001) were independent factors associated with CMR-derived RVEF.

Conclusions: RV volume and RVEF determined by 3D STE were comparable with CMR measurements. Regional RV wall motion showed that heterogeneous segmental deformations affect global RV function differently; specifically, inlet area strain and outflow circumferential strain were significant factors associated with RVEF in patients with underlying heart diseases.

Keywords: Cardiac function; Cardiac volume; Myocardial strain; Right ventricle; Speckle-tracking; Three-dimensional echocardiography.

MeSH terms

Adult
Cross-Sectional Studies
Echocardiography, Three-Dimensional / methods
Female
Heart Ventricles / diagnostic imaging*
Heart Ventricles / physiopathology
Humans
Magnetic Resonance Imaging, Cine / methods
Male
Reproducibility of Results
Retrospective Studies
Stroke Volume / physiology*
Ventricular Dysfunction, Right / diagnosis*
Ventricular Dysfunction, Right / physiopathology
Ventricular Function, Right / physiology*