J Cardiovasc Imaging.  2021 Jul;29(3):236-251. 10.4250/jcvi.2020.0192.

Speckle Tracking Imaging in Patients with Pulmonary Hypertension

• Prieto O
• Cianciulli TF
• Stewart-Harris A
• Rodriguez A
• Saccheri MC
• Lax JA
• Kazelián LR
• Argento LV
• Marambio GM
• Gagliardi JA

• KMID: 2518817
• DOI: http://doi.org/10.4250/jcvi.2020.0192

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 sexmatched 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.

Keyword

Pulmonary hypertension; Right atrial function; Right ventricular function; Strains