Assessment of right ventricular longitudinal strain by 2D speckle tracking imaging compared with RV function and hemodynamics in pulmonary hypertension

Int J Cardiovasc Imaging. 2017 Nov;33(11):1737-1748. doi: 10.1007/s10554-017-1182-3. Epub 2017 May 29.

Abstract

The right ventricular longitudinal strain (RVLS) of pulmonary hypertension (PH) patients and its relationship with RV function parameters measured by echocardiography and hemodynamic parameters measured by right heart catheterization was investigated. According to the WHO functional class (FC), 66 PH patients were divided into FC I/II (group 1) and III/IV (group 2). RV function parameters were measured by echocardiographic examinations. Hemodynamic parameters were obtained by right heart catheterization. Patients in group 2 had higher systolic pulmonary artery pressure (sPAP; P < 0.05) than patients in group (1) significant between-group differences were observed in global RVLS (RVLSglobal), free wall RVLS (RVLSFW; P < 0.01), and RV conventional function parameters (all P < 0.05). Moreover, mPAP and PVR increased remarkably and CI decreased significantly in group (2) RVLSglobal had a positive correlation with 6-min walking distance (6MWD; r = 0.492, P < 0.001) and N-terminal pro-brain natriuretic peptide (NT-proBNP; r = 0.632, P < 0.001), while RVLSFW had a positive correlation with 6MWD (r = 0.483, P < 0.001) and NT-proBNP (r = 0.627, P < 0.001). Hemodynamics analysis revealed that RVLSglobal had a positive correlation with mPAP (r = 0.594, P < 0.001), PVR (r = 0.573, P < 0.001) and CI (r = 0.366, P = 0.003), while RVLSFW had a positive correlation with mPAP (r = 0.597, P < 0.001), PVR (r = 0.577, P < 0.001) and CI (r = 0.369, P = 0.002). According to receiver operating characteristic curves, the optimal cut-off values of RVLSglobal (-15.0%) and RVLSFW (-15.3%) for prognosis detection with good sensitivity and specificity. Evidence has shown that RVLS measurement can provide the much-needed and reliable information on RV function and hemodynamics. Therefore, this qualifies as a patient-friendly approach for the clinical management of PH patients.

Keywords: Hemodynamics; Pulmonary hypertension; Speckle tracking imaging; Ventricular function.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Area Under Curve
  • Arterial Pressure
  • Biomarkers / blood
  • Cardiac Catheterization*
  • Echocardiography / methods*
  • Female
  • Hemodynamics*
  • Humans
  • Hypertension, Pulmonary / blood
  • Hypertension, Pulmonary / diagnostic imaging*
  • Hypertension, Pulmonary / physiopathology
  • Image Interpretation, Computer-Assisted
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Observer Variation
  • Peptide Fragments / blood
  • Predictive Value of Tests
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Artery / physiopathology
  • ROC Curve
  • Reproducibility of Results
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Vascular Resistance
  • Ventricular Dysfunction, Right / blood
  • Ventricular Dysfunction, Right / diagnostic imaging*
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Function, Right*
  • Walk Test

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain