J Cardiovasc Ultrasound.  2014 Jun;22(2):65-71. 10.4250/jcu.2014.22.2.65.

A Comparison of Different Techniques of Two-Dimensional Speckle-Tracking Strain Measurements of Right Ventricular Systolic Function in Patients with Acute Pulmonary Embolism

• Lee JH
• Park JH
• Park KI
• Kim MJ
• Kim JH
• Ahn MS
• Choi SW
• Jeong JO
• Seong IW

• KMID: 2177461
• DOI: http://doi.org/10.4250/jcu.2014.22.2.65

Abstract

BACKGROUND
Speckle-tracking echocardiography has been applied to measure right ventricular (RV) systolic function in various diseases. However, variations in strain measurement by different vendors have limited the application of these techniques for assessment of RV function. We sought to compare two methods for the assessment of RV systolic function in patients with acute pulmonary embolism (PE).
METHODS
From August 2007 to May 2011, all consecutive PE patients were prospectively included in this cohort study. Global longitudinal strains of RV measured with EchoPAC PC software (GLSRV-EchoPAC; GE Medical Systems) and velocity vector imaging (GLSRV-VVI; Siemens Medical Systems) were recorded on the same set of echocardiographic images.
RESULTS
We analyzed a total of 50 patients (12 males, 68 +/- 14 years) with acute PE in this study. GLSRV-EchoPAC and GLSRV-VVI were correlated (r = 0.793, p < 0.001) and they showed significant correlations with conventional echocardiographic parameters of RV systolic function and Log B-type natriuretic peptide (BNP) level. However, GLSRV-VVI only showed significant correlations with cardiac biomarkers as serum creatinine kinase-MB (r = 0.367, p = 0.010) and tropoinin-I concentrations (r = 0.294, p = 0.040).
CONCLUSION
GLSRV-VVI and GLSRV-EchoPAC showed significant correlations with conventional echocardiographic parameters of RV systolic function and LogBNP value in patients with PE.

Keyword

Right ventricle; Pulmonary embolism; Strain echocardiography

MeSH Terms

Biomarkers
Cohort Studies
Commerce
Creatinine
Echocardiography
Heart Ventricles
Humans
Male
Natriuretic Peptide, Brain
Prospective Studies
Pulmonary Embolism*
Creatinine
Natriuretic Peptide, Brain

Figure

• 

  Fig. 1 Correlation between the global longitudinal strain of the right ventricle (GLSRV) values by velocity vector imaging (GLSRV-VVI) and automated function imaging (GLSRV-EchoPAC). They show good correlation (A: scatter plot, B: Bland-Altman plot).

• 

  Fig. 2 Correlations between the global longitudinal strain of the right ventricle by velocity vector imaging (GLSRV-VVI) and echocardiographic parameters and serum B-natriuretic peptide (BNP) level. GLSRV-VVI shows good correlations with an RV fractional area change (RVFAC, A), tricuspid annular plane systolic excursion (TAPSE, B), RV Tei index (C), and LogBNP (D).

• 

  Fig. 3 Correlations between the global longitudinal strain of the right ventricle by automated function imaging (GLSRV-EchoPAC), echocardiographic parameters, and serum B-natriuretic peptide (BNP) level. GLSRV-VVI shows good correlations with an RV fractional area change (RVFAC, A), tricuspid annular plane systolic excursion (TAPSE, B), RV Tei index (C), and LogBNP (D).

• 

  Fig. 4 Receiver operating curve analysis in the detection of right ventricular (RV) systolic dysfunction (determined by an RV fractional area change < 35%). The global longitudinal strain of the right ventricle by velocity vector imaging (GLSRV-VVI) shows a larger area under the curve than does the global longitudinal strain of the right ventricle by automatic function image (GLSRV-EchoPAC). However, there is no statistical significance [difference = 0.07, 95% confidence interval (CI): -0.03-0.17, p = 0.188] in the detection of RV systolic dysfunction.

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