Right ventricular function by strain echocardiography

Right ventricular (RV) function is an independent determinant of prognosis in a number of pathologies, but its accurate quantification by echocardiography remains a challenge. With the evolving clinical utility of RV strain and strain imaging, several studies have used it to investigate normal and pathologic conditions. However, marked shape adaptations of the RV and the wide range of possible loading conditions complicate the interpretation of findings, which will be highlighted in this review.

RV strain and strain rate measurements have been proven feasible and found to offer potential advantages over traditional indices. They allow regional function estimation with less influence from the left ventricle (LV) or overall cardiac motion. However, there are contradictions in recent studies regarding expected values and regional patterns, which may be attributed to differences in imaging techniques but also to the challenging interpretation of findings.

Strain and strain rate have a great potential for a more accurate description of RV function and a better understanding of its pathology. The imaging techniques are ready for translation into the clinical arena, but their greatest utility will only be realized once diagnostic values are more clearly defined.