The WASE normative data on right ventricular motion components: where uniformity meets diversity!

This editorial refers to ‘Three-Dimensional Echocardiographic Evaluation of Longitudinal and Non-Longitudinal Components of Right Ventricular Contraction Results from the World Alliance of Societies of Echocardiography Study’, by J. I. Cotella et al. https://doi.org/10.1093/ehjci/jead213. The right ventricle (RV) has complex anatomy and contractile patterns. The RV myofibre architecture comprises of the superficial circumferential fibres that run parallel to the atrioventricular groove, and the subendocardial fibres that run longitudinally. The RV contraction can be divided into three main components as follows: longitudinal motion that draws the tricuspid annulus towards the apex, radial or inward motion of the RV free wall, and anteroposterior motion following left ventricular contraction.1 Each motion component contributes differentially to the global RV ejection fraction (EF) in various health and disease states. Study in healthy volunteers has shown that the relative contribution of radial and anteroposterior components to the global RVEF was comparable to the longitudinal component.2 In elite athletes, the RV longitudinal deformation predominates and the circumferential deformation is reduced. This functional shift was associated with better exercise capacity.3 In post-cardiac surgery patients, the radial function is increased, while the longitudinal function is reduced.1 In chronic compensated pulmonary hypertension patients, the longitudinal function is increased, while the radial function is reduced, resulting in preserved RVEF.1 Changes in these motion components often precede changes in global RVEF, making them sensitive markers of subclinical RV remodelling.