2D Speckle Tracking Echocardiography in Predicting Diastolic Right Ventricular Dysfunction
Purpose. To develop the prognostic criteria of diastolic dysfunction (DD) of the right ventricle (RV), according to speckle tracking echocardiography (STE). Materials and methods. A clinical and instrumental study of 91 patients aged 64.0 [58.0; 70.0] years was performed on base of the State Institution “Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology” in 2019. The criteria for inclusion in the study were the following: sinus rhythm, essential arterial hypertension, chronic coronary heart disease, previous left myocardial infarction, after which at least six months have passed to stabilize the structural and functional parameters of the left ventricle, chronic heart failure. Exclusion criteria were the following: primary mitral regurgitation, mitral stenosis, mitral valve repair or prosthetics, congenital heart defects, acute and chronic diseases of the kidneys, lungs. Transthoracic echocardiography and STE were performed on the ultrasound machine Vivid E9 (GE Healthcare, USA). Results. The leading functional anomalies that are interconnected with RV DD, with saved RV contractility and RV systolic pressure, are the decrease of RV longitudinal diastolic, regional and global systolic strain, RV mechanical dispersion: statistically significant relationships were revealed between DD and the values of early diastolic longitudinal strain E of the RV basal-septal segment (r=0.63, p<0.001), the RV basal-lateral segment (r=0.61, p <0.001), the ratio of early and late diastolic longitudinal deformations E/A of the RV basal lateral segment (r=-0.66, p<0.001), the global post- systolic index (r=0.45, p=0.0002), the pre-stretch index of the RV lateral wall (r=0.41, p<0.001), RV mechanical dispersion index (r=0.31, p=0.003), RV global longitudinal systolic deformation (GLS) (r=0.61, p<0.001). The values of early diastolic deformation E of the RV basal-septal segment, prognostic for RV DD, are >-5.66% (sensitivity 76.9%, specificity 85.7%), RV basal-lateral segment >-8.74% (sensitivity 91.1%, specificity 70.8%), the ratio of early and late diastolic longitudinal deformations E/A of the RV basal lateral segment ≤0.67 (sensitivity 62.2%, specificity 100.0%), RV GLS >-19.8% (sensitivity 63.8%, specificity 93.1%).Conclusion. The use of the developed STE prognostic indicators in RV DD will increase the efficiency of diagnosis of RV DD.