Cardiovasc Imaging Asia.  2022 Apr;6(2):41-48. 10.22468/cvia.2021.00332.

Global and Regional Right Ventricular Function Investigation by 2D Speckle Tracking Echocardiography in Congenital Heart Disease Patients With Pulmonary Arterial Hypertension

Affiliations
  • 1Adult Congenital Heart Disease Unit, Vietnam National Heart Institute, BachMai Hospital, Hanoi, Vietnam
  • 2Department of Internal Medicine, University of Medicine and Pharmacy, Hanoi National University, Hanoi, Vietnam

Abstract


Objective
The aim of our study was to evaluate the global and regional free wall longitudinal strains of the right ventricle (RV) to detect RV dysfunction in congenital heart disease (CHD) patients with pulmonary arterial hypertension (PAH).
Materials and Methods
Seventy CHD patients with PAH and 30 normal controls were enrolled in this study. Patients were placed into three subgroups including patients with pretricuspid shunt Eisenmenger syndrome (ES) (Group A), patients with post- tricuspid shunt ES (Group B), and patients with non-fixed PAH (Group C). The World Health Organization functional classification (WHO FC) was used to functionally classify the study population. RV free wall strain (FWS); regional RV strains of apical, mid, basal FWS; and RV global longitudinal strain (GLS) were measured by 2D speckle tracking echocardiography (STE), while other parameters were measured by conventional echocardiography.
Results
Forty-three patients (61.4%) were classified as WHO FC III or greater. Mean RVFWS and RVGLS were -20.42%±5.9% and -17.62%±5.5%, respectively. All RV strains including regional FWS were lower in patients compared with healthy controls (p<0.001). RV strains exhibited a higher rate of RV dysfunction compared to the conventional parameters. Mean RVGLS and RVFWS in the two ES groups were lower compared to that in Group C (p<0.001). Within regional trains, basal FWS in Group C was higher than in Group A (p<0.001) but similar to that of Group B. RVFWS, RVGLS, and regional FWS significantly correlated with pulmonary arterial systolic pressure and WHO FC.
Conclusion
In CHD with PAH, 2D-STE parameters are potentially more capable of early detection of RV dysfunction than are conventional echo indices.

Keyword

Speckle tracking; Pulmonary hypertension; Echocardiography; Congenital heart disease
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