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  • Title: Vendor-Neutral Right Ventricular Strain Measurement.
    Author: Gao Z, Bortman J, Mahmood F, Mitchell J, Mahmood F, Matyal R.
    Journal: J Cardiothorac Vasc Anesth; 2018 Aug; 32(4):1759-1767. PubMed ID: 29555385.
    Abstract:
    OBJECTIVE: To test the feasibility and reliability of using a vendor-neutral platform to evaluate right ventricular (RV) strain. Reliability was determined by comparing intra- and inter-observer variability between RV strain assessments. The secondary objective was to assess strain's correlation with conventional RV functional parameters to evaluate its feasibility as a RV systolic functional assessment tool. DESIGN: This is a retrospective study. SETTING: Tertiary hospital. PARTICIPANTS: A total of 15 patients who underwent elective coronary artery bypass graft surgery were selected for inclusion. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Images obtained during routine, intraoperative, two-dimensional transesophageal echocardiography (2D TEE) were assessed for longitudinal strain (LS) and conventional parameters, including fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), Doppler tissue imaging (DTI)-derived tricuspid lateral annular systolic velocity wave (S'), and RV dimensions using vendor-neutral software. There was good to excellent intra- and inter-observer reproducibility (intraclass correlation coefficient [ICC] from 0.75 to 1.00) with the exception of basal free wall longitudinal strain (FWLS) (for intra- and inter-observer reproducibility, ICC = 0.670 and 0.749, respectively). FWLS and global longitudinal strain (GLS) showed moderate to strong positive correlation with FAC, TAPSE, and S' (correlation coefficients from 0.667 to 0.721). CONCLUSION: It is feasible to assess RV strain across multiple platforms in a reproducible and reliable fashion. Furthermore, RV strain demonstrated good correlation with conventional RV functional parameters, suggesting its feasibility as a sensitive RV function assessment tool.
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