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.