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Reproducibility of right ventricular function by longitudinal strain and other echocardiographic parameters in the ELSA-Brasil study

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Abstract

Right ventricular (RV) free wall longitudinal strain (RVFWLS), and four-chamber longitudinal strain (RV4CLS) using speckle tracking echocardiography have demonstrated increased accuracy and discrimination to measure right ventricular function in different clinical conditions. Reproducibility data of these measures are scarce and mainly tested in small or reference populations. The main objective of this study was to investigate their reproducibility, and of other traditional RV parameters, from unselected participants of a large cohort study. RV strain reproducibility was analyzed using echocardiographic images of 50 participants from a randomly selected sample from The ELSA-Brasil Cohort. Images were acquired and analyzed following the study protocols. The mean RVFWLS was − 26.9 ± 2.6% and the mean RV4CLS was − 24.4 ± 1.9%. The intra-observer reproducibility parameters of RVFWLS demonstrated a coefficient of variation (CV) of 5.1% and an intraclass correlation coefficient (ICC [95%CI] 0.78[0.67—0.89]), and for RV4CLS were CV = 5.1% and ICC = 0.78[0.67—0.89]. Reproducibility for RV fractional area change was CV = 12.1%; ICC = 0.66 [0.50—0.81] and for RV basal diameter was CV = 6.3%; ICC = 0.82 [0.73—0.91]. The inter-observer reproducibility for RVFWLS was CV = 8.3%; ICC 0.54[0.34—0.74] and for RV4CLS, CV = 6.3%; ICC = 0.53[0.34—0.73], following the same pattern among conventional RV parameters. We found adequate reproducibility of RV longitudinal strain parameters. This information is relevant for the long-term follow-up of cohort participants and reinforces the utility of RV longitudinal strain as a tool to monitor subclinical changes in RV systolic function.

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Funding

This work was supported by the Brazilian Ministry of Health (Science and Technology Department), the Brazilian Ministry of Science, Technology and Innovation (Financiadora de Estudos e Projetos-grants 01 06 0010.00, 01 10 0643.00 RS, 01 06 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00 SP, 01 06 0071.00 RJ), CNPq (the Brazilian National Council for Scientific and Technological Development).

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Authors and Affiliations

  1. Postgraduate Program in Cardiology and Cardiovascular Sciences, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil

    Eduardo G. Pianca, Giulia B. Schmitz, Murilo Foppa & Angela B. S. Santos

  2. Cardiology Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Sala 2061, Porto Alegre, Rio Grande do Sul, RS, ZIP Code 90035-903, Brazil

    Giulia B. Schmitz, Murilo Foppa & Angela B. S. Santos

  3. Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil

    Bruce B. Duncan

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  1. Eduardo G. Pianca
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  4. Murilo Foppa
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  5. Angela B. S. Santos
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Contributions

All authors contributed to the study’s conception and design. Data collection was performed by EGP and GBS. Material preparation and data analysis were performed by EGP. The first draft of the manuscript was written by EGP and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Angela B. S. Santos.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Because it is a multicenter study, ELSA-Brasil’s research protocol was approved not only by the ethics committee of each institution but also by the National Research Ethics Committee.

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Pianca, E.G., Schmitz, G.B., Duncan, B.B. et al. Reproducibility of right ventricular function by longitudinal strain and other echocardiographic parameters in the ELSA-Brasil study. Int J Cardiovasc Imaging 39, 1865–1870 (2023). https://doi.org/10.1007/s10554-023-02899-7

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