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As an integral part of the mitral valve apparatus, the left ventricle papillary muscle (PM) controls mitral valve closure during systole and participates in the ejection process during left ventricular systole. Mitral regurgitation (MR) is the most immediate and predominant result when the PM is structurally or functionally abnormal. However, dysfunction of the PM is easily underestimated or overlooked in clinical interventions for MR-related diseases. Therefore, adequate recognition of PM dysfunction and PM-derived MR is critical. In this review, we systematically describe the normal anatomical variations in the PM and the pathophysiology of PM dysfunction-related diseases and summarize the commonly used parameters and the advantages and disadvantages of various noninvasive imaging modalities for the structural and functional assessment of the PM. [ABSTRACT FROM AUTHOR]

Pulmonary regurgitation usually leads to right heart dilatation and eventually right heart dysfunction, which is associated with a poor prognosis. Transcatheter pulmonary valve replacement is a developing treatment for pulmonary valve dysfunction that can take the place of traditional surgery and make up for the shortcomings of a large injury. Echocardiography plays a significant role in assessing ventricular function; however, conventional echocardiographic parameters have several limitations. Speckle tracking echocardiography has been regarded as a more accurate tool for quantifying cardiac function than conventional echocardiography. Therefore, the aim of this review was to summarize the application of speckle tracking echocardiography for evaluating right and left ventricular functions in patients after transcatheter pulmonary valve replacement. [ABSTRACT FROM AUTHOR]

Pulmonary regurgitation usually leads to right heart dilatation and eventually right heart dysfunction, which is associated with a poor prognosis. Transcatheter pulmonary valve replacement is a developing treatment for pulmonary valve dysfunction that can take the place of traditional surgery and make up for the shortcomings of a large injury. Echocardiography plays a significant role in assessing ventricular function; however, conventional echocardiographic parameters have several limitations. Speckle tracking echocardiography has been regarded as a more accurate tool for quantifying cardiac function than conventional echocardiography. Therefore, the aim of this review was to summarize the application of speckle tracking echocardiography for evaluating right and left ventricular functions in patients after transcatheter pulmonary valve replacement.

Background: Right ventricular free wall longitudinal strain (RVFWLS) carries important diagnostic and prognostic significance in a variety of clinical settings, but its measurement is time consuming and operator dependent, limiting its value in routine clinical practice. Automated RVFWLS measurements can overcome these limitations. The purpose of this study was to determine the feasibility, reproducibility, and prognostic implications of automated RVFWLS compared with manual assessment of RVFWLS., Methods: A total of 206 patients with a wide range of right ventricular (RV) function were retrospectively selected for this study. Fully automated (Auto-Strain), semiautomated (automated with editing), and manual (standard manual assessment) RVFWLS were measured using two-dimensional speckle-tracking echocardiography in the same RV-focused apical four-chamber view. RV ejection fraction (RVEF) was measured using three-dimensional echocardiography. Abnormal RV systolic function was defined as RVEF < 45%. Agreement for RVFWLS measurements among the three different methods was based on a combination of Pearson correlation, Bland-Altman analyses, and coefficients of variation (CVs)., Results: Automated RVFWLS measurements were feasible in 204 subjects (99%). Automated (8 ± 1 sec/patient) and semiautomated (50 ± 10 sec/patient) assessments had shorter analysis times compared with manual measurement (103 ± 25 sec/patient, P < .001 for both). Semiautomated RVFWLS had a stronger correlation with manual RVFWLS than automated RVFWLS (r = 0.850 vs r = 0.708, P < .001). Semiautomated RVFWLS had smaller biases, narrower limits of agreement (LOA), and lower CVs against manual assessment in comparison with the fully automated method in the whole study population (bias of 0.62 and 1.15, LOA of 6.54 and 10.50, and CVs of 9.3% and 16.9%, respectively), in the subgroup with RVEF < 45% (bias of 0.81 and 1.43, LOA of 6.32 and 10.42, and CVs of 10.2% and 18.6%, respectively), and in those with RVEF ≥ 45% (bias of 0.34 and 0.73, LOA of 6.86 and 10.63, and CVs of 8.0% and 14.5%, respectively). Seventy-six patients experienced adverse cardiovascular events during a median follow-up period of 26 months. Fully automated, semiautomated, and manual RVFWLS were associated with poor outcomes. The prognostic implications of fully automated RVFWLS were inferior to those of semiautomated and manual RVFWLS. Three RVFWLS measurements were highly reproducible., Conclusions: Both fully automated and semiautomated RVFWLS provide rapid and reproducible assessments of RV function and carry important prognostic implication. Moreover, the semiautomated approach performs better than the fully automated method. Therefore, semiautomated RVFWLS can provide a better balance between feasibility and clinical significance and displays potential for clinical application., (Copyright © 2022 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)