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Nonvolumetric Echocardiographic Indices of Right Ventricular Systolic Function: Validation with Cardiovascular Magnetic Resonance and Relationship with Functional Capacity

Authors

  • Darryl P. Leong M.B.B.S., M.P.H., Ph.D.,

    1. Flinders Centre for Cardiovascular Magnetic Resonance Research (FCCMR), Flinders University of South Australia, Adelaide, Australia
    2. Cardiovascular Research Centre, Department of Cardiology, Royal Adelaide Hospital and the Discipline of Medicine, University of Adelaide, Adelaide, Australia
    3. Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia
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  • Suchi Grover M.B.B.S.,

    1. Flinders Centre for Cardiovascular Magnetic Resonance Research (FCCMR), Flinders University of South Australia, Adelaide, Australia
    2. Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia
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  • Payman Molaee M.B.B.S.,

    1. Cardiovascular Research Centre, Department of Cardiology, Royal Adelaide Hospital and the Discipline of Medicine, University of Adelaide, Adelaide, Australia
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  • Adhiraj Chakrabarty B.Sc.,

    1. Flinders Centre for Cardiovascular Magnetic Resonance Research (FCCMR), Flinders University of South Australia, Adelaide, Australia
    2. Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia
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  • Mitra Shirazi M.D.,

    1. Cardiovascular Research Centre, Department of Cardiology, Royal Adelaide Hospital and the Discipline of Medicine, University of Adelaide, Adelaide, Australia
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  • Yi H. Cheng,

    1. Cardiovascular Research Centre, Department of Cardiology, Royal Adelaide Hospital and the Discipline of Medicine, University of Adelaide, Adelaide, Australia
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  • Amy Penhall B.Sc.,

    1. Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia
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  • Rebecca Perry B.Sc.,

    1. Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia
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  • Hugh Greville M.B.B.S.,

    1. Department of Respiratory Medicine, Royal Adelaide Hospital, Adelaide, Australia
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  • Majo X. Joseph M.B.B.S.,

    1. Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia
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  • Joseph B. Selvanayagam M.B.B.S., D.Phil.

    1. Flinders Centre for Cardiovascular Magnetic Resonance Research (FCCMR), Flinders University of South Australia, Adelaide, Australia
    2. Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia
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  • Sources of Funding: Dr. Leong is supported by a Medical Postgraduate Scholarship funded jointly by the National Health and Medical Research Council of Australia and the National Heart Foundation of Australia, and is a recipient of the Dawes Scholarship from the Royal Adelaide Hospital. Dr. Molaee is supported by a Medical Postgraduate Scholarship funded jointly by the National Health and Medical Research Council of Australia and the National Heart Foundation of Australia. Dr. Selvanayagam is funded by the National Heart Foundation of Australia.

Dr. Darryl P. Leong, M.B.B.S., M.P.H., Ph.D., Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, South Australia 5042, Australia. Fax: +61 8 82045625; E-mail: darryl.leong@adelaide.edu.au

Abstract

Purpose: Right ventricular (RV) systolic function as measured by right ventricular ejection fraction (RVEF) has long been recognized as an important predictor of outcome in heart failure patients. The echocardiographic measurement of RV volumes and RVEF is challenging, however, owing to the unique geometry of the right ventricle. Several nonvolumetric echocardiographic indices of RV function have demonstrated prognostic value in heart failure. Comparison studies of these techniques with each other using RVEF as a benchmark are limited, however. Furthermore, the contribution of these various elements of RV function to patient functional status is uncertain. We therefore aimed to: (1) Determine which nonvolumetric echocardiographic index correlates best with RVEF as determined by cardiac magnetic resonance (CMR) imaging (the accepted gold standard measure of RV systolic function) and (2) Ascertain which echocardiographic index best predicts functional capacity. Methods: Eighty-three subjects (66 with systolic heart failure and 17 healthy controls) underwent CMR, 2D echocardiography, and cardiopulmonary exercise testing for comparison of echocardiographic indices of RV function with CMR RVEF, 6-minute walk distance and VO2 PEAK. Results: Speckle tracking strain RV strain exhibited the closest association with CMR RV ejection fraction. Indices of RV function demonstrated weak correlation with 6-minute walk distance, but basal RV strain rate by tissue velocity imaging had good correlation with VO2 PEAK. Conclusion: Strain by speckle tracking echocardiography and strain rate by tissue velocity imaging may offer complementary information in the evaluation of RV contractility and its functional effects. (Echocardiography 2012;29:455-463)

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