Key result
Apical right ventricular strain was significantly lower in patients with dilated cardiomyopathy compared to normal subjects, and a cut-off value of ≤29.5% identified RV dysfunction with 91.2% sensitivity and 100% specificity.
Why the study?
RV dysfunction predicts morbidity and mortality in DCM, and heterogeneous segmental deformation affects global RV function, motivating assessment of apical versus basal RV strain.
Does apical RV strain reflect right ventricular dysfunction better than basal RV strain in patients with dilated cardiomyopathy?
Cross-Sectional (n=70)
No
Does apical RV strain reflect right ventricular dysfunction better than basal RV strain in patients with dilated cardiomyopathy?
Absolute Event Rate: -17.3% vs 36.7%
p-value: p=<0.001
Apical RV strain, but not basal RV strain, is significantly reduced in patients with dilated cardiomyopathy and can accurately distinguish RV dysfunction from normal.
Apical RV strain may identify dysfunction in dilated cardiomyopathy better than basal; leaves open its prognostic or therapeutic utility.
Background RV dysfunction is an important predictor of morbidity and mortality in cardiac patients, especially those having dilated cardiomyopathy (DCM). Deformation imaging parameters (strain and strain rate) are established as new echocardiographic measures that allow for both global and regional RV function assessment. Previous studies showed that heterogeneous segmental deformation affects global RV function differently in various disease states. Echo-Doppler parameters of RV and LV function including RV global longitudinal strain, basal & apical RV strain, LV ejection fraction and LV global longitudinal strain were evaluated in 42 DCM patients & 28 normal subjects, aiming to assess the value of apical versus basal RV strain in detection of RV dysfunction in patients with dilated cardiomyopathy. Results DCM patients had significantly lower values of both RV global longitudinal strain and apical RV strain compared to normal subjects ( p < 0.001). Basal RV strain did not significantly differ in DCM from normal. The apical RV strain correlated significantly with RV global longitudinal strain, LV ejection fraction and LV global longitudinal strain ( p < 0.001 for all). Using ROC curve, a cut-off value of apical RV strain ≤ 29.5 distinguished RV dysfunction from normal with 91.2% sensitivity & 100% specificity. Conclusions RV apical but not basal strain reflects the status of RV function, and it represents a valuable measure to diagnose RV dysfunction in patients with DCM.
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Ali et al. (2023) conducted a cross-sectional in Dilated cardiomyopathy (n=70). Dilated cardiomyopathy vs. Normal subjects was evaluated on Apical RV strain (p=<0.001). Apical right ventricular strain was significantly lower in patients with dilated cardiomyopathy compared to normal subjects, and a cut-off value of ≤29.5% identified RV dysfunction with 91.2% sensitivity and 100% specificity.
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