145 Right ventricular function assessment in PAH patients: a two-dimensional strain and three-dimensional echocardiographic study.

Background: Right ventricular (RV) function has major prognostic implications for pulmonary arterial hypertension (PAH). RV function assessment by echocardiography is challenging in PAH patients. New techniques such as two-dimensional strain (2DS) and three dimension (3D) echocardiography may allow assessment of RV function. Objective: We sought to determine among echocardiographic techniques – those widely used, 2DS and 3D – which one was the best correlated to magnetic resonance imaging (MRI) measurements. Methods: Fourteen patients with PAH (mean age 58 +/- 17 yr, 7 women) were evaluated. RV fractional area change (RVFAC), Tei index, peak systolic velocity (S), Tricuspid Annular Plane Systolic Excursion (TAPSE) were measured. Global and segmental RV longitudinal deformations were recorded by 2DS echocardiography from 4 apical-chamber views using 6 segments RV model. Echocardiographic system designed for 3D was Tomtec. Results: TAPSE, peak S and RVFAC were lower in PAH patients than control and correlated to MRI (p<0.005). Global and free wall strain measured by 2DS and ejection fraction VD (FEVD) by MRI (r=0.73; p< 0.005) were inversely correlated. The 3D volume and 3D FEVD were strongly correlated to corresponding measurements obtained by MRI (volume: r=0.88; p<0.005) (FE: r=0.85; p<0.005). Conclusion: Both 2DS and 3D echocardiography techniques are strongly correlated to MRI. Simple and reliable 2DS could be preferred to 3D. [Copyright &y& Elsevier]