Key result
Two-dimensional speckle-tracking echocardiography showed good agreement with cardiac magnetic resonance feature-tracking for measuring right ventricular global longitudinal strain (bias = -0.9648).
Why the study?
Right heart remodeling commonly occurs and worsens prognosis in CTEPH, but the feasibility of 2D-STE for assessing RV remodeling in these patients needed evaluation.
Does 2D-speckle tracking echocardiography accurately assess right ventricular remodeling compared to cardiac magnetic resonance in patients with chronic thromboembolic pulmonary hypertension?
Observational (n=21)
Single-blind
No
Does 2D-speckle tracking echocardiography accurately assess right ventricular remodeling compared to cardiac magnetic resonance in patients with chronic thromboembolic pulmonary hypertension?
Answers are grounded in this paper and cite their sources.
2D-speckle tracking echocardiography is a feasible alternative to cardiac magnetic resonance for assessing right ventricular global longitudinal strain and remodeling in patients with chronic thromboembolic pulmonary hypertension.
Background Right heart remodeling occurs in a substantial proportion of patients with chronic thromboembolic pulmonary hypertension (CTEPH) and significantly affects their prognosis. Two-dimensional speckle-tracking echocardiography (2D-STE) can be used to evaluate myocardial deformation under physiological and pathological conditions. This study aimed to assess the feasibility of 2D-STE for evaluating right ventricular (RV) remodeling in CTEPH patients. Methods This retrospective study included 21 CTEPH patients who underwent transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR). Data for the following parameters that can reflect RV function were collected: tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), right ventricular index of myocardial performance (RIMP), peak systolic velocity of the tricuspid annulus (S'), and CMR-right ventricular ejection fraction (CMR-RVEF). The following strain parameters were calculated using post-processing software: STE-RV global longitudinal strain (STE-RVGLS), STE-RV free wall longitudinal strain (STE-RVFWLS), and CMR-RVGLS. Results As CMR-RVEF deteriorated, RV remodeling in CTEPH patients became more apparent and was mainly characterized by significant enlargement of the RV, weakening of myocardial deformation, and a decrease in RV contractility (RV area, STE-RVFWLS, STE-RVGLS: mild vs. severe and moderate vs. severe, p < 0.05; CMR-RVGLS: mild vs. severe, p < 0.05; TAPSE: moderate vs. severe, p < 0.05). Moreover, the Pearson correlation coefficient for correlation with CMR-derived RVEF was stronger for RVFWLS than for CMR-GLS (r-value: 0.70 vs. 0.68), and the strain values measured by 2D-STE showed a weak correlation with right heart catheterization data. Bland-Altman analysis showed good agreement between 2D-STE and CMR-feature tracking (FT) for RVGLS (bias = −0.96; 95% limit of agreement from −8.42 to 6.49). Conclusions For the measurement of RVGLS, 2D-STE is similarly feasible to CMR-FT and could sensitively identify right heart remodeling.
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Wang et al. (2022) conducted an observational in Chronic thromboembolic pulmonary hypertension (CTEPH) (n=21). 2D-speckle tracking echocardiography (2D-STE) vs. Cardiac magnetic resonance feature-tracking (CMR-FT) was evaluated on Agreement between 2D-STE and CMR-FT for right ventricular global longitudinal strain (RVGLS) (bias = -0.9648, 95% CI -8.422 to 6.493). Two-dimensional speckle-tracking echocardiography showed good agreement with cardiac magnetic resonance feature-tracking for measuring right ventricular global longitudinal strain (bias = -0.9648).
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