Division of Pediatric Cardiology, Duke University Medical Center, Durham, North Carolina.
Department of Cardiology, Gentofte University Hospital, Gentofte, Denmark.
J Am Soc Echocardiogr. 2014 Apr;27(4):413-22. doi: 10.1016/j.echo.2013.12.018. Epub 2014 Feb 6.
Although quantitative right ventricular (RV) strain analysis may be useful in congenital and acquired heart disease populations with RV failure, a comprehensive, standardized approach is lacking. An 18-segment RV strain analysis obtained from three standardized RV apical echocardiographic images was used to determine the feasibility, normal values, and reproducibility of the method in normal adults.
Forty healthy, prospectively enrolled volunteers with no cardiac histories and normal QRS durations underwent echocardiography optimized for strain analysis including three RV apical views. Two-dimensional speckle-tracking longitudinal strain analysis was performed using EchoPAC software. Eleven retrospectively identified subjects with RV disease were included as a pilot population. All had been imaged using the same protocol including the three RV apical views.
All control subjects had normal anatomic morphology and function by echocardiography. Feasibility of the RV strain analysis was good (adequate tracking in 696 of 720 segments [97%]). RV global peak systolic strain was -23 ± 2%. Peak strain was highest in the RV free wall and lowest in the septum. Dyssynchrony indices demonstrated no dyssynchrony using left ventricular criteria. Reproducibility of most strain measures was acceptable. This methodology identified important disease not seen in the four-chamber apical view alone in the pilot population of 11 patients with RV disease. Strain patterns and values were different from those in the control population, indicating that differences do exist from normal.
Eighteen-segment RV strain analysis is feasible, with strain measures falling into discrete ranges in this normal population. Those with RV disease illustrate the potential utility of this approach. These data indicate that this model can be used for more detailed studies evaluating abnormal RV populations, in which its full potential can be assessed.
尽管定量右心室（RV）应变分析可能对 RV 衰竭的先天性和获得性心脏病患者有用，但缺乏全面、标准化的方法。本研究使用三个标准化 RV 心尖超声心动图图像获得的 18 节段 RV 应变分析，旨在确定该方法在正常成年人中的可行性、正常值和可重复性。
40 名无心脏病史和正常 QRS 持续时间的健康前瞻性志愿者接受了优化的应变分析超声心动图检查，包括三个 RV 心尖视图。使用 EchoPAC 软件进行二维斑点追踪纵向应变分析。11 名 RV 疾病的回顾性患者作为试点人群。所有患者均使用相同的协议进行成像，包括三个 RV 心尖视图。
所有对照组的超声心动图均显示正常的解剖形态和功能。RV 应变分析的可行性良好（696/720 个节段[97%]可进行适当追踪）。RV 整体收缩期峰值应变值为-23±2%。应变峰值在 RV 游离壁最高，在间隔最低。使用左心室标准，同步性指数未见不同步。大多数应变测量的可重复性可以接受。这种方法在 11 名 RV 疾病患者的试点人群中发现了仅四腔心心尖视图无法识别的重要疾病。应变模式和值与对照组不同，表明与正常人群存在差异。
18 节段 RV 应变分析是可行的，应变值在正常人群中呈离散范围。RV 疾病患者表明该方法具有潜在的应用价值。这些数据表明，该模型可用于更详细地评估异常 RV 人群的研究，以评估其全部潜力。
