Skip to main content
Log in

Multiplane two-dimensional strain echocardiography for segmental analysis of right ventricular mechanics

New-RV study

  • Original Paper
  • Published:
Clinical Research in Cardiology Aims and scope Submit manuscript

Abstract

Introduction

Recent studies showed the prognostic value of strain measurements of the free right ventricular (RV) wall. The aim of this study was to evaluate the feasibility and the diagnostic value of the assessment of longitudinal mechanics of all segments of the RV by multiplane, two-dimensional transthoracic (2D) strain echocardiography.

Methods

A triplane apical visualization of the RV was attempted in each individual. RV systolic function was assessed with RV 2D strain, RV automated systolic index, real-time 3D echocardiography and RV parameters according to current guidelines.

Results

The study population (n = 118) consisted of 81 consecutive patients with overt right ventricular systolic dysfunction due to different etiologies, 13 patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and 24 healthy controls. Triplane assessment of the RV was possible in all examinations. 2D strain of 18 segments could be obtained in 75 %, 9 segments of the RV free wall in 84 % and 3 segments in four-chamber view in 96 % of the examinations. Contrary to established RV parameters, RV 2D strain detected impaired RV function in all patient groups compared to the control group. In regard to global RV function, RV 2D strain by multiplane assessment was not superior to a monoplane approach. However, segmental strain analysis was able to define the presence of impaired RV function in ARVC patients which otherwise would have been missed by current standard parameters.

Conclusion

Regional RV mechanics were reliably assessed by RV 2D strain in a multiplane apical chamber view mode.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Voelkel NF, Quaife RA, Leinwand LA, Barst RJ, McGoon MD, Meldrum DR, Dupuis J, Long CS, Rubin LJ, Smart FW, Suzuki YJ, Gladwin M, Denholm EM, Gail DB (2006) Right ventricular function and failure: report of a national heart, lung, and blood institute working group on cellular and molecular mechanisms of right heart failure. Circulation 114:1883–1891

    Article  PubMed  Google Scholar 

  2. Mereles D, Grünig E (2006) A stepwise and practical approach to optimizing echocardiography in pulmonary hypertension. Adv Pulm Hypertens 5:30–33

    Google Scholar 

  3. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American society of echocardiography endorsed by the European association of echocardiography, a registered branch of the European society of cardiology, and the Canadian society of echocardiography. J Am Soc Echocardiogr 23:685–713

    Article  PubMed  Google Scholar 

  4. Borges AC, Knebel F, Eddicks S, Panda A, Schattke S, Witt C, Baumann G (2006) Right ventricular function assessed by two-dimensional strain and tissue Doppler echocardiography in patients with pulmonary arterial hypertension and effect of vasodilator therapy. Am J Cardiol 98:530–534

    Article  CAS  PubMed  Google Scholar 

  5. Filusch A, Mereles D, Gruenig E, Buss S, Katus HA, Meyer FJ (2010) Strain and strain rate echocardiography for evaluation of right ventricular dysfunction in patients with idiopathic pulmonary arterial hypertension. Clin Res Cardiol 99:491–498

    Article  PubMed  Google Scholar 

  6. Puwanant S, Park M, Popović ZB, Tang WH, Farha S, George D, Sharp J, Puntawangkoon J, Loyd JE, Erzurum SC, Thomas JD (2010) Ventricular geometry, strain, and rotational mechanics in pulmonary hypertension. Circulation 121:259–266

    Article  PubMed Central  PubMed  Google Scholar 

  7. van der Zwaan HB, Geleijnse ML, McGhie JS, Boersma E, Helbing WA, Meijboom FJ, Roos-Hesselink JW (2011) Right ventricular quantification in clinical practice: two-dimensional vs. three-dimensional echocardiography compared with cardiac magnetic resonance imaging. Eur J Echocardiogr 12:656–664

    Article  PubMed  Google Scholar 

  8. Tamborini G, Brusoni D, Torres Molina JE, Galli CA, Maltagliati A, Muratori M, Susini F, Colombo C, Maffessanti F, Pepi M (2008) Feasibility of a new generation three-dimensional echocardiography for right ventricular volumetric and functional measurements. Am J Cardiol 102:499–505

    Article  PubMed  Google Scholar 

  9. Greiner S, André F, Heimisch M, Heß A, Steen H, Katus HA, Mereles D (2012) Non-invasive quantification of right ventricular systolic function by echocardiography: a new semi-automated approach. Clin Res Cardiol 102:229–235

    Article  PubMed  Google Scholar 

  10. Marwick TH, Leano RL, Brown J, Sun JP, Hoffmann R, Lysyansky P, Becker M, Thomas JD (2009) Myocardial strain measurement with 2-dimensional speckle-tracking echocardiography definition of normal range. J Am Coll Cardiol 2:80–84

    Article  Google Scholar 

  11. Szulik M, Pappas CJ, Jurcut R, Magro M, Peeters E, Goetschalckx K, Rademakers F, Desmet W, Voigt JU (2011) Clinical validation of a novel speckle-tracking–based ejection fraction assessment method. J Am Soc Echocardiogr 24:1092–1100

    Article  PubMed  Google Scholar 

  12. Rudski LG, Afilalo J (2012) The blind men of Indostan and the elephant in the echo lab. J Am Soc Echocardiogr 25:714–717

    Article  PubMed  Google Scholar 

  13. Platz E, Hassanein AH, Shah A, Goldhaber SZ, Solomon SD (2012) Regional right ventricular strain pattern in patients with acute pulmonary embolism. Echocardiography 29:464–470

    Article  PubMed  Google Scholar 

  14. Teske AJ, Cox MG, Te Riele AS, De Boeck BW, Doevendans PA, Hauer RN, Cramer MJ (2012) Early detection of regional functional abnormalities in asymptomatic ARVD/C gene carriers. J Am Soc Echocardiogr 25:997–1006

    Article  PubMed  Google Scholar 

  15. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ (2005) Recommendations for chamber quantification: a report from the American society of echocardiography’s guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the European association of echocardiography, a branch of the European society of cardiology. J Am Soc Echocardiogr 18:1440–1463

    Article  PubMed  Google Scholar 

  16. Buss SJ, Emami M, Mereles D, Korosoglou G, Kristen AV, Voss A, Schellberg D, Zugck C, Galuschky C, Giannitsis E, Hegenbart U, Ho AD, Katus HA, Schonland SO, Hardt SE (2012) Longitudinal left ventricular function for prediction of survival in systemic light-chain amyloidosis: incremental value compared with clinical and biochemical markers. J Am Coll Cardiol 60:1067–1076

    Article  PubMed  Google Scholar 

  17. Sachdev A, Villarraga HR, Frantz RP, McGoon MD, Hsiao JF, Maalouf JF, Ammash NM, McCully RB, Miller FA, Pellikka PA, Oh JK, Kane GC (2011) Right ventricular strain for prediction of survival in patients with pulmonary arterial hypertension. Chest 139:1299–1309

    Article  PubMed  Google Scholar 

  18. Haeck ML, Scherptong RW, Marsan NA, Holman ER, Schalij MJ, Bax JJ, Vliegen HW, Delgado V (2012) Prognostic value of right ventricular longitudinal peak systolic strain in patients with pulmonary hypertension. Circ Cardiovasc Imaging 5:628–636

    Article  PubMed  Google Scholar 

  19. Guendouz S, Rappeneau S, Nahum J, Dubois-Randé JL, Gueret P, Monin JL, Lim P, Adnot S, Hittinger L, Damy T (2012) Prognostic significance and normal values of 2D strain to assess right ventricular systolic function in chronic heart failure. Circ J 76:127–136

    Article  PubMed  Google Scholar 

  20. Ho SY, Nihoyannopoulos P (2006) Anatomy, echocardiography, and normal right ventricular dimensions. Heart 92:i2–i13

    Article  PubMed Central  PubMed  Google Scholar 

  21. Haddad F, Doyle R, Murphy DJ, Hunt SA (2008) Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation 117:1717–1731

    Article  PubMed  Google Scholar 

  22. Marcus FI, McKenna WJ, Sherrill D, Basso C, Bauce B, Bluemke DA, Calkins H, Corrado D, Cox MG, Daubert JP, Fontaine G, Gear K, Hauer R, Nava A, Picard MH, Protonotarios N, Saffitz JE, Sanborn DM, Steinberg JS, Tandri H, Thiene G, Towbin JA, Tsatsopoulou A, Wichter T, Zareba W (2010) Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the task force criteria. Circulation 121:1533–1541

    Article  PubMed Central  PubMed  Google Scholar 

  23. Yoerger DM, Marcus F, Sherrill D, Calkins H, Towbin JA, Zareba W, Picard MH, Multidisciplinary study of right ventricular dysplasia investigators (2005) Echocardiographic findings in patients meeting task force criteria for arrhythmogenic right ventricular dysplasia: new insights from the multidisciplinary study of right ventricular dysplasia. J Am Coll Cardiol 45:860–865

    Article  PubMed  Google Scholar 

  24. Oxborough D, Sharma S, Shave R, Whyte G, Birch K, Artis N, Batterham AM, George K (2012) The right ventricle of the endurance athlete: the relationship between morphology and deformation. J Am Soc Echocardiogr 25:263–271

    Article  PubMed  Google Scholar 

  25. La Gerche A, Burns AT, D’Hooge J, Macisaac AI, Heidbüchel H, Prior DL (2012) Exercise strain rate imaging demonstrates normal right ventricular contractile reserve and clarifies ambiguous resting measures in endurance athletes. J Am Soc Echocardiogr 25:253–262

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sebastian Greiner.

Additional information

Clinical Trials Registration

www.clinicaltrials.gov. Unique identifier: NCT01230294.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Greiner, S., Heimisch, M., Aurich, M. et al. Multiplane two-dimensional strain echocardiography for segmental analysis of right ventricular mechanics. Clin Res Cardiol 103, 817–824 (2014). https://doi.org/10.1007/s00392-014-0723-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00392-014-0723-1

Keywords

Navigation