Clinical Research in Cardiology

, Volume 99, Issue 8, pp 491–498 | Cite as

Strain and strain rate echocardiography for evaluation of right ventricular dysfunction in patients with idiopathic pulmonary arterial hypertension

  • Arthur FiluschEmail author
  • Derliz Mereles
  • Ekkehard Gruenig
  • Sebastian Buss
  • Hugo A. Katus
  • F. Joachim Meyer
Original Paper


Optimizing the non-invasive imaging of right ventricular (RV) function is of increasing interest for therapy monitoring and risk stratification in patients with idiopathic pulmonary hypertension (IPAH). Therefore, this study evaluated strain and strain rate echocardiography as a tool for comprehensive assessment of RV function and disease severity in IPAH patients. In 30 IPAH patients [WHO functional classes II–IV; mean pulmonary artery pressure (mPAP) 48.8 ± 12.5 mmHg; pulmonary vascular resistance (PVR) 7.9 ± 5.3 Wood units] and in 10 matched healthy control subjects’ two-dimensional echocardiography, 6-MWD and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were obtained. In IPAH patients when compared with controls, RV systolic strain (−18.8 ± 4.3 vs. −34.5 ± 3.8%, p = 0.0016) and strain rate (−1.6 ± 0.6 vs. −2.7 ± 0.5 s−1, p = 0.018) were significantly altered and correlated significantly with elevated NT-proBNP levels (r = 0.73 and r = 0.62; p < 0.001, respectively) and reduced 6-MWD (r = −0.76 and r = −0.81; p < 0.001). In IPAH patients, reduced strain correlated with both mPAP (r = 0.61, p = 0.01 for strain; and r = 0.55, p = 0.04 for strain rate, respectively), and PVR (r = 0.84, p < 0.001 for strain; and r = 0.67, p < 0.001 for strain rate, respectively). This study gives first comprehensive evidence that strain echocardiography allows accurate non-invasive assessment of RV function and disease severity in patients with IPAH.


Idiopathic pulmonary arterial hypertension Pulmonary hemodynamics Strain echocardiography Heart failure Biomarkers 


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Arthur Filusch
    • 1
    Email author
  • Derliz Mereles
    • 1
  • Ekkehard Gruenig
    • 2
  • Sebastian Buss
    • 1
  • Hugo A. Katus
    • 1
  • F. Joachim Meyer
    • 1
  1. 1.Department of Cardiology, Angiology and PneumologyUniversity of HeidelbergHeidelbergGermany
  2. 2.Department of Pulmonary and Respiratory Critical Care MedicineThoraxclinicHeidelbergGermany

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