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Year : 2018  |  Volume : 31  |  Issue : 2  |  Page : 395-401

Right ventricular mechanics in patients with idiopathic dilated cardiomyopathy using strain imaging

1 Department of Cardiology, Menoufia University, Menoufia, Egypt
2 Department of Cardiology, Al Ahrar Teaching Hospital, Al Dakahlya, Egypt

Correspondence Address:
Ehab E Mahdy
Department of Cardiology, Al Ahrar Teaching Hospital, Mit Ghamr, Al Dakahlya
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_671_16

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Objectives The aim of this study was to assess right ventricular (RV) mechanics in patients with idiopathic dilated cardiomyopathy (DCM) using two-dimensional (2D) strain imaging technique. Background Imaging using strain and strain rate (SR) was recently applied as a promising tool to analyze global and regional myocardial function in different disease entities, including DCM. 2D strain echo would be especially useful in assessing DCM as an accurate, time-sparing method. Patients and methods A total of 104 patients with documented DCM as proved by echocardiography were investigated using 2D echo, and 25 age-matched and sex-matched individuals served as control. Off-line 2D strain analysis was performed for the assessment of global and regional strain of the RV, including the RV free wall and the interventricular septum. Results RV deformation parameters showed loss of longitudinal systolic strain and SR base to apex gradient and significantly declined values in the DCM group. The averaged RV free wall segment systolic strain (−9.84 ± 6.73 vs. −30.86 ± 4.44%), systolic strain rate (SRsys) (−0.88 ± 0.47 vs. −1.75 ± 0.68 s−1), and early systolic strain rate (SRe) (0.67 ± 0.50 vs. 2.08 ± 1.08 s−1) were significantly reduced in the DCM group compared with the control group (P < 0.0001). These findings were also apparent in global RV deformation and gave similar significance (P < 0.0001) with the exception of late diastolic SR (P = NS). Intraventricular dyssynchrony was verified and showed a significant increase in time-to-peak standard deviation in the DCM group (75.71 ± 47.76 vs. 44.18 ± 26.72 ms, P < 0.002) compared with the control group. Conclusion In conclusion, our results suggest that the same cardiomyopathic pathology affects the RV as much as it affects the left ventricle with reduction in both RV systolic and diastolic functions. We have made an attempt to understand RV mechanics in different cardiac pathologies.

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