Right heart function in impaired left ventricular diastolic function: 2D speckle tracking echocardiography–based and Doppler tissue imaging–based analysis of right atrial and ventricular function

Aim The aim of our study was to describe right atrial ( RA ) and right ventricular ( RV ) function, assessed by Doppler tissue imaging and 2D speckle tracking echocardiography (2DSTE), in women with signs of early impaired left ventricular diastolic function ( DD ). Methods and Results In a cross‐sectional trial, standard parameters of diastolic and right heart function were investigated in 438 women of the Berlin Female Risk Evaluation ( BEFRI ) study. In a subset of women, average peak systolic RA strain ( RAS ), as well as the average peak systolic RV strain of the free wall ( RVS free wall) and of all RV segments (average RV strain; RVS Avg), was analyzed using 2DSTE. Compared to women with normal diastolic function ( DD 0), RAS , RVS free wall and RVS Avg were significantly reduced in DD (43.1% ± 11.9%, −26.7% ± 5.6%, and −23.3% ± 3.5% in DD 0; vs 35.1% ± 10.4%, −23.9% ± 5.5%, and −20.6% ± 3.8% in DD ; P  < .01). Peak RV myocardial velocity ( RV ‐ IVV ) and acceleration during isovolumetric contraction ( RV ‐ IVA ) were markedly higher in DD (15.0 ± 3.9 cm/s and 3.1 ± 1.0 m/s² in DD vs 11.9 ± 3.2 cm/s and 2.8 ± 0.8 m/s² in DD 0; P  < .05). RAS and RV ‐ IVV were significantly associated with DD after adjustment to age, BMI , and left atrial strain in multivariate regression analysis. Conclusion Systolic right heart function is significantly altered in DD . DTI as well as 2DSTE constitute sensitive echocardiographic tools that enable the diagnosis of impaired right heart mechanics in early‐staged DD .