Right ventricular tissue Doppler and strain imaging: ready for clinical use?

Area of Science:

• Cardiology
• Echocardiography
• Medical Imaging

Background:

• Left ventricle (LV) tissue Doppler (TD) imaging is common, but right ventricle (RV) TD imaging is underutilized.
• Established normal values and clinical data exist for RV TD imaging (color and spectral).
• RV impairment is linked to depressed RV TD velocities in acute LV inferior wall myocardial infarction.

Purpose of the Study:

• To highlight the clinical utility of RV TD imaging.
• To demonstrate RV TD's value in assessing RV function and predicting outcomes.
• To emphasize RV TD and strain imaging as crucial additions to echocardiography.

Main Methods:

• Utilized color and spectral TD imaging for RV assessment.
• Correlated TD imaging with radionuclide angiography and MRI for RV ejection fraction.
• Calculated RV performance (Tei) index using TD-derived time intervals.
• Employed TD-derived RV strain imaging to detect segmental dysfunction.

Main Results:

• RV TD velocities correlate with RV impairment and outcomes in myocardial infarction and heart failure.
• RV TD imaging is valuable in congenital heart disease, correlating with invasive hemodynamics and MRI.
• RV TD indices detect subclinical and clinical disease in obesity, pulmonary, and systemic conditions.
• TD-derived RV strain imaging overcomes limitations of conventional TD by detecting segmental dysfunction.

Conclusions:

• RV TD imaging is a valuable tool for assessing RV function and predicting outcomes in diverse clinical scenarios.
• RV TD and strain imaging are reproducible, rapid, and easily integrated into echocardiographic protocols.
• These techniques enhance the comprehensive assessment of RV function, despite requiring awareness of their limitations.