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Objective To evaluate right ventricular ( RV) global and regional systolic function in patients with atrial septal defect ( ASD) before and after percutaneous closure using real time three-dimensional echocardiography ( RT3 DE). Methods RT3 DE was performed in 81 patients with ASD within 24 hours before and after percutaneous closure to obtain RV global and regional ejection fraction ( EF) in three compartments (inflow, body, and outflow). RV fractional area change ( FAC), tricuspid annular plane systolic excursion ( TAPSE), peak tricuspid systolic velocity (S), and pulmonary vascular resistance ( PVR) were recorded. Forty matched normal adults were included as controls. Results When compared with controls, RV global and regional EF were decreased in preclosure patients (P < 0.001). FAC was lower while TAPSE and S were higher in preclosure patients than in controls (P < 0.05). After closure, RV systolic function parameters were all reduced (P < 0.001). Regional EF in the body compartment was the lowest among the three compartments in ASD patients (P < 0.05). Procedural percentage changes of RV global EF and regional EF in the inflow compartment were lower than those of two-dimensional systolic function parameters (P < 0.05). RV global and regional EF in the inflow compartment were negatively correlated with PVR in patients after closure (r = −0.601, −0.543, P < 0.001). Conclusions RV global and regional systolic functions are impaired in open and closed ASD. RT3 DE-derived systolic function parameters are negatively correlated with RV after load. RT3 DE has potential value in the evaluation of RV systolic function in patients with ASD. [ABSTRACT FROM AUTHOR]

Background The reference values and impact of physiologic variables on echocardiographic quantification of left ventricular (LV) longitudinal and circumferential layer-specific myocardial strains in large series of healthy persons remain unknown. This study prospectively investigated the impact of age, gender, and other physiologic parameters on LV longitudinal and circumferential layer-specific myocardial strains. Methods 119 healthy volunteers (age range, 22-76; 50% women) underwent echocardiography. Short-axis (for circumferential strain) and apical (for longitudinal strain) views were analyzed using modified speckle tracking software enabling the analysis of strains in three myocardial layers. Results In normal subjects, longitudinal and circumferential strain was highest in the endocardium and lowest in the epicardium, longitudinal and circumferential three-layer strain was highest in the apex and lowest in the base. The mean global longitudinal strain in the endocardial layer (GLS-endo), in the mid-myocardial layer (GLS-mid) and in the epicardial layer (GLS-epi) were −24.3 ± 3.1%, −21.3 ± 2.9%, and −18.9 ± 2.8%, respectively. Gender, HR, and SV (stroke volume) were independent predictors of GLS-endo, GLS-mid, and GLS-epi. The mean global circumferential strain in the endocardial layer (GCS-endo), in the mid-myocardial layer (GCS-mid) and in the epicardial layer (GCS-epi) were −34.3 ± 4.4%, −20.5 ± 3.0%, and −11.8 ± 2.7%, respectively. HR independently predicted GCS-endo, GCS-mid, and GCS-epi. Conclusions Three-layer analysis of longitudinal and circumferential strain using two-dimensional speckle tracking imaging (2DSTI) can be performed on a clinical basis and may become an important method for the assessment of real time, quantitative global, and regional LV function. [ABSTRACT FROM AUTHOR]

Objective: To evaluate right ventricular (RV) regional volume and systolic function in patients with pulmonary arterial hypertension (PAH) using real time three-dimensional echocardiography (RT3DE), and to explore the relationship between parameters measured by RT3DE and right heart catheterization (RHC). Methods: RT3DE images were acquired from 24 patients with PAH and 27 normal controls for evaluation and analysis to obtain RV regional end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF) in three compartments (inflow, body, and outflow). Conventional echocardiographic parameters were calculated and recorded. RHC was performed in 17 patients to obtain pulmonary artery systolic pressure (PASP) and pulmonary vascular resistance (PVR). Results: RV regional EDV and ESV were significantly higher while regional EF was significantly lower in the PAH patients when compared with controls (P < 0.001). In the PAH group, EDV was similar in the inflow and body compartment, both higher than that in the outflow compartment (P < 0.05); EF was the highest in the inflow compartment and the lowest in the body compartment (P < 0.05). RV regional EF in the inflow compartment and global EF were negatively correlated with PASP (r =-0.766, -0.816, P < 0.001) and PVR (r =-0.529, -0.656, P < 0.05). Conclusions: In patients with PAH, RV regional volume was enlarged and systolic function was impaired with distinct characteristics; regional EF in the inflow compartment and global EF were inversely correlated with PASP and PVR. Evaluation of RV regional systolic function using RT3DE may play a potential role in the noninvasive assessment of the severity of PAH. (Echocardiography 2012;29:706-712) [ABSTRACT FROM AUTHOR]