Regional, age and sex differences of the right ventricular function assessed by a novel 12 segment approach

Introduction: Because of the complex morphology of the right ventricle (RV), no single imaging plane will provide enough information to assess adequately the RV function. 2D speckle tracking (STE) has proved to be an accurate technique for the assessment of RV function. However, normal values for RV deformation refer only to the RV free wall, excluding the contribution of the other RV walls. Methods: Using a new 12-segment model, we defined regional, age, and sex differences of the RV deformation by STE in normal individuals. Methods: 70 normal subjects (48 ± 15 years, 34 men) with adequate 2D images in 4C and 2C RV views were evaluated for RV function by STE. RV function was assessed by regional strain at the level of each wall: lateral (LS), septal (SS), inferior (IS) and anterior (AS), and also strain for 4C (4CGS), 2C (2CGS), and global RV strain (RVGS). Systolic strain rate (GSRs), early and late diastolic SR (GSRe, GSRl) were assessed separately for 4C, 2C and global RV. 3 age groups have been defined: < 40, 40 – 59 and > 60 years. Results: Septal deformation was lower than the other 3 RV walls (LS, IS, and AS), and this difference remained for all 3 age groups. Global systolic strain and SR parameters were similar irrespective to age. Global diastolic SR parameters were modified, with lower value for SRe over 40 years and higher value for SRl over 60 years (both p < 0.01). GSRe was better in women, in each of the 3 age groups (1,6 ± 0,4 women vs. 1,3 ± 0,3 men), whereas all other S and SR parameters were similar Conclusions: Parameters of RV deformation had regional, age and sex differences; thus, septal deformation is lower, while women had better global early diastolic SR than men. Intrinsic diastolic RV function (GSRe) decreases, whereas GSRl increases compensatory with age. This might be of particularly clinical interest in diseases with regional RV dysfunction.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)