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Right Ventricular Strain in Pulmonary Arterial Hypertension: A 2D Echocardiography and Cardiac Magnetic Resonance Study
Author(s) -
Freed Benjamin H.,
Tsang Wendy,
Bhave Nicole M.,
Patel Amit R.,
Weinert Lynn,
Yamat Megan,
Vicedo Beatriz Miralles,
Dill Karin,
MorAvi Victor,
GombergMaitland Mardi,
Lang Roberto M.
Publication year - 2015
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12662
Subject(s) - cardiology , medicine , strain (injury) , cardiac magnetic resonance , reproducibility , pulmonary hypertension , magnetic resonance imaging , ejection fraction , longitudinal study , population , cardiac magnetic resonance imaging , speckle tracking echocardiography , radiology , pathology , heart failure , statistics , mathematics , environmental health
Background Right ventricular ( RV ) strain is a potentially useful prognostic marker in patients with pulmonary arterial hypertension ( PAH ). However, published reports regarding the accuracy of two‐dimensional echocardiography (2 DE )‐derived RV strain against an independent reference in this patient population are limited. The aims of this study were: (1) to study the relationship between 2 DE RV longitudinal strain and cardiovascular magnetic resonance ( CMR )‐derived RV ejection fraction ( RVEF ) in patients with PAH ; (2) to compare 2 DE ‐derived and CMR ‐derived RV longitudinal strain in these patients; and (3) to determine the reproducibility of these measurements. Methods Thirty patients with PAH underwent 2 DE and CMR imaging within a 2‐hour time period. 2 DE RV longitudinal strain was measured from a focused RV apical four‐chamber view using speckle tracking software. CMR RV longitudinal strain was measured from short‐axis slices acquired using fast‐strain‐encoded sequence. Global peak systolic RV longitudinal strain was calculated for both 2 DE and CMR . Results RV longitudinal strain using 2 DE software correlated well with CMR ‐derived RVEF (R = 0.69, P = 0.0006). There was moderate agreement when comparing 2 DE to CMR RV longitudinal strain (R = 0.74, P = 0.0002; bias −1%, limits of agreement −9 to 7%). Inter‐observer variability and intra‐observer variability for RV longitudinal strain were lower for 2 DE than CMR . Conclusions RV longitudinal strain by 2 DE provides a good alternative for CMR ‐derived RVEF in patients with PAH . The moderate agreement in strain measurements between 2 DE and CMR suggests that further software improvements are needed before these measurements can be used interchangeably in clinical practice.