Strain and Strain Rate To Evaluate Right Heart Function of Ebstein Anomaly (EA) Patients Before and After Operation
Evaluation Right Heart Function of Ebstein Anomaly
Keywords:Ebstein Anomaly, right ventricular function, tissue Doppler imaging, strain
Objective: This study was aimed to elucidate the feasibility of using right ventricular (RV) strain and strain rate to evaluate right heart function of Ebstein anomaly (EA) patients before and after operation.
Methods: Sixty EA patients and 30 healthy controls underwent echocardiography (UCG) for evaluation of right heart function. Preoperative UCG and 1-week and 3-month postoperative UCG were performed in EA patients. RV strain and strain rate were measured on the four-chamber section of tissue Doppler imaging (TDI).
Results: The strain and strain rate representative of right ventricle systolic function were reduced prior to operation. RV strain and strain rate improved after the operation
(P < .001), most significantly in the basal segment and middle segment of the free wall of the right ventricle as well as the basal segment of the interventricular septum (P < .001).
Conclusions: The measurement of RV strain and strain rate on tissue Doppler imaging can be employed to assess the preoperative and postoperative RV function, proves the positive effect of tricuspid valve repair on right heart function, and offers more insight on right heart function evaluation.
Aneq MA, Engvall J, Brudin L, Nylander E. 2012. Evaluation of right and left ventricular function using speckle tracking echocardiography in patients with arrhythmogenic right ventricular cardiomyopathy and their first degree relatives. Cardiovasc Ultrasound. 10:37–41.
Antoni ML, Scherptong RW, Atary JZ, et al. 2010. Prognostic value of right ventricular function in patients after acute myocardial infarction treated with primary percutaneous coronary intervention. Circ Cardiovasc Imaging. 3:264-271.
Bos JM, Hagler DJ, Silvilairat S, et al. 2006. Right Ventricular Function in Asymptomatic Individuals with a Systemic Right Ventricle. J Am Soc Echocardiogr. 19:1033-1037.
Cameli M, Lisi M, Righini FM, et al. 2012. Right ventricular longitudinal strain correlates well with right ventricular stroke work index in patients with advanced heart failure referred for heart transplantation. J Card Fail. 18:208-215.
Hardegree EL, Sachdev A, Villarraga HR, et al. 2013. Role of serial quantitative assessment of right ventricular function by strain in pulmonary arterial hypertension. Am J Cardiol. 111:143–148.
Hayek S, Sims DB, Markham DW, Butler J, Kalogeropoulos AP. 2014. Assessment of right ventricular function in left ventricular assist device candidates. Circ Cardiovasc Imaging. 7:379–389.
Kjaergaard J, Petersen CL, Kjaer A, Schaadt BK, Oh JK, Hassager C. 2006. Evaluation of right ventricular volume and function by 2D and 3D echocardiography compared to MRI. Eur J Echocardiography. 7:430-438.
Kukulski T, Hubbert L, Arnold M, et al. 2000. Normal regional right ventricular function and its change with age: a Doppler myocardial imaging study. J Am Soc Echocardiography. 13:194-204.
Lang RM, Bierig M, Devereux RB, et al. 2005. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 18:1440–1463.
Lu JC, Ghadimi Mahani M, Agarwal PP, Cotts TB, Dorfman AL. 2013. Usefulness of right ventricular free wall strain to predict quality of life in “repaired” tetralogy of Fallot. Am J Cardiol. 111:1644–1649.
Prakasa KR, Wang J, Tandri H, et al. 2007. Utility of tissue Doppler and strain echocardiography in arrhythmogenic right ventricular dysplasia cardiomyopathy. Am J Cardiol. 100:507-512.
Rasalingam R, Johnson SN, Bilhorn KR, et al. 2011. Transthoracic echocardiographic assessment of continuous-flow left ventricular assist devices. J Am Soc Echocardiography. 24:135-148.
Teske AJ, De Boeck BW, Olimulder M, Prakken NH, Doevendans PA, Cramer MJ. 2008. Echocardiographic assessment of regional right ventricular function: a head-to-head comparison between 2-dimensional and tissue Doppler-derived strain analysis. J Am Soc Echocardiography. 21:275-283.
Zhang X, Wu Q, Dong B, Li H, Zhang M, Jin Y. 2018. The outcomes of operation for 237 patients with Ebstein anomaly. Chin J Surg. 56: 418-421.