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1 INSERM E0226 and Louis Pradel Hospital, Claude Bernard Lyon-I University, Lyon, France
* To whom correspondence should be addressed. E-mail: fadi.jamal{at}chu-lyon.fr.
The assessment of the contractile function of the right ventricle (RV) is an important clinical issue, but remains difficult because of its complex anatomy and structure. We thought to investigate whether new Doppler-derived myocardial deformation indices may quantify regional contractile RV function during varying loading conditions. In nine pigs, ultrasonic crystals were inserted longitudinally in the RV inflow and outflow tract, to assess regional contractile function. The same RV segments and the interventricular septum were imaged using apical echocardiographic views. Regional function was assessed using 2 parameters: (1) systolic strain (SS) representing the relative magnitude of segmental systolic shortening, and (2), its temporal derivative peak systolic strain rate (SR), i.e. the maximal velocity of segmental shortening. Data was acquired at baseline, during partial pulmonary artery constriction (PAC) and inferior vena cava occlusion (IVCO). SS decreased significantly after PAC and IVCO both in the inflow and outflow tracts, but only during IVCO in the septum. SR was less sensitive to loading variations in all segments. A significant correlation was found between SS values derived from sonomicrometry and myocardial Doppler in RV segments (r=0.84, p<0.001). Thus, regional strain and strain rate provide complementary information on the heterogeneous RV contractile function and can be accurately and non-invasively quantified using Doppler myocardial imaging.
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