Why the study?
To compare echocardiographic right ventricular strain to FAC%, TAPSE, and S' in assessing RV systolic function using cardiac MRI as the reference standard.
Does right ventricular strain measured by echocardiography accurately detect impaired right ventricular systolic function compared to cardiac MRI in patients undergoing cardiac imaging?
Does right ventricular strain measured by echocardiography accurately detect impaired right ventricular systolic function compared to cardiac MRI in patients undergoing cardiac imaging?
Right ventricular strain is the most accurate echocardiographic parameter for detecting impaired right ventricular systolic function when compared to the cardiac MRI gold standard.
RV strain shows only modest accuracy for detecting RV dysfunction versus MRI; leaves open its clinical role pending prospective validation.
INTRODUCTION: The right ventricle (RV) strain measured by speckle tracking (RVS) is an echocardiographic parameter used to assess RV function. We compared RVS to RV fractional area change (FAC%), tricuspid annular plane systolic excursion (TAPSE) and Doppler tissue imaging-derived peak systolic velocity (S') in the assessment of right ventricular (RV) systolic function measured using cardiac magnetic resonance imaging (MRI). METHODS: We enrolled consecutive patients who underwent cardiac MRI between Jan 2012 and Dec 2017 and a transthoracic echocardiogram (TTE) within 1 month of the MRI with no interval event. Baseline clinical characteristics and MRI parameters were extracted from chart review. Echocardiographic parameters were measured prospectively. TTE parameters including RVS, TAPSE, S', and FAC% were tested for accuracy to identify impaired RV EF (EF < 45% & <30%) using receiver operator curves. RESULTS: The study cohort included 500 patients with mean age 55 years ± 18 and peak tricuspid regurgitation velocity 2.7 ± 1.4 m/s. The area under ROC for RVS was 0.69 (95% CI 0.63-0.75) and 0.78 (95% CI 0.70-0.88) to predict RVEF < 45% & RVEF < 30%, respectively. The RV FAC% had second highest accuracy of predicting RVEF among all the TTE parameters tested in study. CONCLUSION: Right ventricular strain is the most accurate echocardiographic method to detect impaired right ventricular systolic function when using MRI as the gold standard.
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Agasthi et al. (2020) studied this question.
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