Right ventricular strain in heart failure: Clinical perspective
Marijana Tadic1, Elisabeth Pieske-Kraigher1, Cesare Cuspidi2
1Department of cardiology, Charité-university-medicine Berlin, Berlin, Germany.
Archives of Cardiovascular Diseases
|July 4, 2017
Summary
Right ventricular dysfunction worsens outcomes in heart failure patients, regardless of ejection fraction. Speckle-tracking echocardiography, assessing right ventricular strain, is crucial for evaluating heart failure patients and requires further investigation for routine clinical use.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Echocardiography
Background:
- Right ventricular remodelling is increasingly recognized in cardiovascular diseases.
- Speckle-tracking imaging offers detailed insights into right ventricular function and mechanics.
- Right ventricular dysfunction is linked to increased mortality in heart failure.
Purpose of the Study:
- To review current knowledge on right ventricular mechanics in heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF).
- To highlight the role of speckle-tracking imaging in assessing right ventricular function.
- To discuss the clinical implications of right ventricular strain in heart failure management.
Main Methods:
- Systematic literature search of PubMed, MEDLINE, Ovid, and Embase databases (January 2000–December 2016).
- Keywords included: "right ventricle"; "strain"; "speckle tracking"; "heart failure with reduced ejection fraction"; and "heart failure with preserved ejection fraction".
- Review of studies focusing on right ventricular mechanics and function in heart failure populations.
Main Results:
- Right ventricular dysfunction is associated with higher mortality in heart failure, irrespective of ejection fraction.
- Studies on right ventricular strain in HFrEF are increasing.
- Data on right ventricular mechanics in HFpEF are limited.
Conclusions:
- Right ventricular strain assessment via speckle-tracking echocardiography is feasible, accurate, and clinically significant in heart failure.
- Routine inclusion of right ventricular strain evaluation in echocardiographic examinations for heart failure patients is recommended.
- Further research is needed to establish right ventricular strain as a standard decision-making variable.
Keywords:
Déformation (strain)Heart failureInsuffisance cardiaqueInsuffisance cardiaque à fraction d’éjection ventriculaire gauche préservéeInsuffisance cardiaque à fraction d’éjection ventriculaire gauche réduitePreserved ejection fractionReduced ejection fractionRight ventricleStrainVentricule droit
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