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PLoS One. 2014 Aug 4;9(8):e103717. doi: 10.1371/journal.pone.0103717. eCollection 2014.

Right ventricular function quantification in Takotsubo cardiomyopathy using two-dimensional strain echocardiography.

Author information

1
First Medical Department, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
2
Department of Cardiology, Center of Cardiovascular Medicine, Bad Neustadt, Germany.
3
Department of Biometrics and Statistics, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.

Abstract

AIMS:

This study sought to characterize global and regional right ventricular (RV) myocardial function in patients with Takotsubo cardiomyopathy (TC) using 2D strain imaging.

METHODS:

We compared various parameters of RV and left ventricular (LV) systolic function between 2 groups of consecutive patients with TC at initial presentation and upon follow-up. Group 1 had RV involvement and group 2 did not have RV involvement.

RESULTS:

At initial presentation, RV peak systolic longitudinal strain (RVPSS) and RV fractional area change (RVFAC) were significantly lower in group 1 (-13.2±8.6% vs. -21.8±5.4%, p = 0.001; 30.7±9.3% vs. 43.5±6.3%, p = 0.001) and improved significantly upon follow-up. Tricuspid annular plane systolic excursion (TAPSE) did not differ significantly at initial presentation between both groups (14.8±4.1 mm vs. 17.9±3.5 mm, p = 0.050). Differences in regional systolic RV strain were only observed in the mid and apical segments. LV ejection fraction (LVEF) and LV global strain were significantly lower in group 1 (36±8% vs. 46±10%, p = 0.006 and -5.5±4.8% vs. -10.2±6.2%, p = 0.040) at initial presentation. None of the parameters were significantly different between the 2 groups upon follow-up. A RVPSS cut-off value of >-19.1% had a sensitivity of 85% and a specificity of 71% to discriminate between the 2 groups.

CONCLUSION:

In TC, RVFAC, RVPSS, LVEF and LV global strain differed significantly between patients with and without RV dysfunction, whereas TAPSE did not. 2 D strain imaging was feasible for the assessment of RV dysfunction in TC and could discriminate between patients with and without RV involvement in a clinically meaningful way.

PMID:
25089702
PMCID:
PMC4121208
DOI:
10.1371/journal.pone.0103717
[Indexed for MEDLINE]
Free PMC Article

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