Speckle Tracking Imaging in Patients with Pulmonary Hypertension

Area of Science:

• Cardiology
• Echocardiography
• Pulmonary Hypertension

Background:

• Right ventricular (RV) systolic dysfunction is a key mortality predictor in pulmonary hypertension (PH).
• Current 2D echocardiography methods may not fully capture RV systolic function.

Purpose of the Study:

• To evaluate if right atrium (RA) and RV myocardial strain, assessed by speckle tracking echocardiography, offer superior RV systolic function estimation compared to 2D echocardiography in PH patients.

Main Methods:

• A cross-sectional study involving 22 PH patients (stratified by right heart catheterization) and 22 matched healthy controls.
• Speckle tracking echocardiography was used to measure RV and RA myocardial strain.

Main Results:

• Mean longitudinal strain in the RV free wall did not differ significantly between apical and subcostal views (p = 0.99).
• Patients with PH showed significantly impaired mean longitudinal strain and strain rate in the right atrial free wall.
• RV free wall longitudinal strain did not correlate with 2D echocardiography measurements of RV systolic function.

Conclusions:

• Speckle tracking strain assessment reveals impaired RV contractility in PH.
• Subcostal RV strain is a viable alternative to apical views, especially with poor acoustic windows.
• RA strain and strain rates are potentially valuable additions for assessing right-sided heart function in PH.