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OBJECTIVES Right ventricular (RV) function is identified as a key determinant of the outcome in patients with pulmonary hypertension (PH). Several studies have assessed the role of peak global longitudinal RV strain in PH patients; however, less emphasis was given to the RV regional longitudinal strain. The aim of this study was to evaluate the regional RV systolic strain in PH patients and investigate the relationship of these parameters with the severity of PH. METHODS RV regional longitudinal peak systolic strain (LPSS) and strain rate (LPSSR) were measured using speckle tracking echocardiography on 100 patients with PH who underwent right heart catheterization, and 29 control subjects. Severe PH was identified by a decreased cardiac index (CI) (

Purpose We evaluated ventricular rotation, torsion, and strain changes in infants using preoperative and postoperative M-mode echocardiography after early surgery for symptomatic ventricular septal defects (VSD). Methods Thirty-five patients with VSD underwent vector velocity imaging echocardiography before and after open heart surgery. Their rotational variables were compared with 18 controls. Results All the patients (19 boys and 16 girls; median age: 44.4 days; range: 13-84 days) showed normal septal motion preoperatively; however, septal motion changed into flat septum or paradoxical septal motion after surgery. Left ventricular end-diastolic internal dimension and fractional shortening significantly decreased after surgery (P = .001 and P = .000). Patients showed significant postoperative reduction of peak systolic apical rotation and maximal torsion (P = .010 and P = .000). Peak systolic basal rotation decreased after surgery but it was not significantly (P = .106). No significant differences were found in longitudinal and circumferential systolic strains between patients and controls. Conclusion Abnormal motion of the ventricular septum was confirmed by postoperative M-mode echocardiography. Decreased rotation/torsion variables may reflect postoperative changes of ventricular loading conditions. Because systolic strain was preserved, postoperative echocardiographic results should not be interpreted as abnormal or decreased ventricular function.

Objectives The aim of this study was to clarify the influence of the ASD closure by occluder device on right ventricular acute and long-term changes in longitudinal systolic strains, by evaluating right ventricular wall deformation in children using speckle tracking echocardiography (STE). Methods and materials We enrolled 30 children with ASDs and 40 controls in our study. The Amplatzer atrial defect occluder was used to close the ASDs. Transthoracic echocardiographic examinations were performed at 3 points in time: the day before closure, 1 day after closure, and 3 months after closure. The dimensions of the right atrium (RA) and the right ventricle (RV) were measured in apical four-chamber view. RV segmental longitudinal systolic strains (SLSs) and global longitudinal systolic strain (GLS) were obtained by two-dimensional STE. Results Before ASD closure, the RV SLSs and GLS were significantly higher than those of the controls. At 1 day after closure, the diameters of RA and RV decreased. All the RV SLSs and GLS decreased accordingly and were lower than the control values. At 3 months after closure, the apical free wall strain, all segments of septal strains, and GLS increased significantly compared with the values obtained at 1 day after closure. The diameters of the RA and RV decreased further as well. There were no significant differences in the strains compared with the control values, except for the free wall basal strain. Conclusions Transcatheter device closure of ASDs improves RV strain indices and RV function recover to normal over 3 months.

Purpose To evaluate the myocardial dysfunction in the early stage of nonhemorrhagic stroke and its association with the National Institutes of Health Stroke Scale (NIHSS) score, by two-dimensional speckle tracking echocardiography. Methods We included 29 patients with acute ischemic stroke, in whom NIHSS scores were calculated and stroke infarct volumes recorded. Within 48 hours of admission, cardiac evaluation with speckle tracking echocardiography was performed and left ventricular global longitudinal strain (GLS) and global longitudinal systolic strain rate were obtained. These measurements were repeated on the 10th day. Results NIHSS score improved, but infarct volume increased (p = 0.011 and 0.065, respectively) from admission to day 10. Ejection fraction was 53.2% and 55.8%, respectively, at admission and day 10 (p = 0.482), while GLS improved from −16.41% to −18.76% (p = 0.003). Conclusions GLS and global longitudinal systolic strain rate showed significant improvement together with NIHSS score. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound, 2016

Objective Quantification of fetal right ventricular (RV) function by 2D-echocardiography is challenging. Velocity vector imaging (VVI) is an angle independent speckle tracking technique that assesses regional myocardial mechanics. Alteration in the deformation of the fetal RV in hypoplastic left heart syndrome (HLHS) is unknown. This study aimed to evaluate the regional mechanics of the fetal RV in HLHS. Methods We retrospectively analyzed HLHS fetuses imaged at our center. Velocity, strain and strain rate were obtained using VVI. Global and regional parameters of RV deformation were compared between HLHS fetuses and gestational age matched controls. Results A total of 30 HLHS fetuses and 30 gestational age matched controls were analyzed. The mean gestational age was 30.5 ±3.5 weeks. Global myocardial strain was significantly decreased in HLHS RVs compared to controls (−1.9% vs. -4.1%, p = 0.003). The volume of the hypoplastic left ventricle did not affect RV deformation in HLHS. Conclusions Compared to controls, the RV in HLHS fetuses has decreased systolic strain. Prenatal abnormalities in RV myocardial deformation may be responsible for inefficient cardiac performance and output. RV myocardial performance in HLHS can be measured prenatally and may be predictive of post-natal RV dysfunction. © 2012 John Wiley & Sons, Ltd.

A 45-year-old female breast cancer patient developed heart failure during adjuvant trastuzumab therapy. Her initial left ventricular ejection fraction (LVEF) was 39% and corresponding global longitudinal and circumferential systolic strain measurements were also significantly reduced. Trastuzumab was ceased and supportive cardiac therapy commenced. The ensuing LVEF and systolic strain measurements showed consistent improvement so that trastuzumab was recommenced (while supportive cardiac therapy continued). At this point, reduced circumferential systolic strain with preserved LVEF was observed. Subsequent echocardiograms revealed further reductions in circumferential and longitudinal systolic strain without reductions in LVEF.

Septal systolic strain measurements showed reduced longitudinal function but its localized nature failed to demonstrate radial disturbances in patients with pathologically thickened septum. No diff ...

Background: We previously reported right ventricular outflow tract (RVOT) pacing results in a greater cardiac output comparing with mid-septal (RVMS) and apical (RVA) pacing. However, the precise mechanism of the RVOT pacing predominance is unknown. [Purpose] We aimed to clarify the pacing-site-dependent differences in left ventricular (LV) synchronization, and compared them according to the atrio-ventricular conductivity. Methods: In 76 patients, the LV wall motion was visualized by 2D strain echocardiography (2DSE) and the SD in the time-to-peak systolic strain was measured in 18 LV segments. The differences in the LV synchronization were assessed between the sick sinus syndrome (SSS) and complete atrio-ventricular block (cAVB) patient groups. Results: The SD in the time to peak systolic strain was smaller with RVOT pacing than RVMS or RVA with no remarkable difference between the RVMS and RVA. In the SSS group (n=31), RVOT pacing tended to minimize the SD compared with RVMS and RVA (69.9±4.3, 77.8±4.7 vs. 82.8±5.4 ms), whereas the cAVB group (n=24) exhibited no significant difference in the SD among the three pacing positions (68.8±3.0, 73.9±4.4 vs. 76.0±3.7 ms). Conclusion: The beneficial effect of RVOT pacing was depicted clearly by 2DSE. However, the superiority of the RVOT over the RVMS and RVA differed according to the atrio-ventricular conductivity.