Open AccessClinical study of right ventricular longitudinal strain for assessing right ventricular dysfunction and hemodynamics in pulmonary hypertension
Author(s) -
Yidan Li,
Yidan Wang,
Xiaoguang Ye,
Lin Kong,
Wenzhen Zhu,
Xiuzhang Lu
Publication year - 2016
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000005668
Subject(s) - medicine , cardiology , pulmonary hypertension , hemodynamics , ventricular function , diastole , doppler echocardiography , receiver operating characteristic , diastolic function , blood pressure
This study aimed to appraise the application of right ventricular longitudinal strain for assessing right ventricular dysfunction and severe hemodynamic changes in pulmonary hypertension. The study included 53 patients clinically diagnosed with PH. Tissue Doppler–derived tricuspid lateral annular systolic velocity (s’), early diastolic peak velocity (e’), late diastolic peak velocity (a’), tricuspid annular plane systolic excursion (TAPSE), RV index of myocardial performance (RIMP), and right ventricular fractional area change (FAC) were determined. The STI parameter was RV free wall longitudinal peak systolic strain (RV LPSS). The patients were assigned into two groups based on a RV LPSS value of − 19%. RV LPSS, s’, TAPSE, RIMP, FAC, a’ and e’/a’ showed significant differences. PH patients with an RV LPSS≥ −19% exhibited a lower RV function ( P < 0.05). RV LPSS was negatively correlated with TAPSE ( r = −0.326, P < 0.05) and FAC ( r = −0.495, P < 0.001) and positively correlated with RIMP ( r = 0.508, P < 0.001). The optimal cut-off value of RV LPSS to reveal an mPAP ≥ 45 mmHg defined based on the receiver operating characteristic curve analysis was − 19.26% with a sensitivity of 83.9% and a specificity of 73.4%. Distinguishing the degree of RV dysfunction by 2D-STI may help physicians to determine the state of cardiac function and degree of PH in patients and offer a basis for subsequent clinical diagnosis and therapy. Our study demonstrates the superiority of RV LPSS for uncovering severe PH over the traditional echocardiographic parameters.