Right ventricular systolic function in severe functional tricuspid regurgitation: predictive value of longitudinal strain
Authors:
Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
For correspondence: Sign in or register.
Type: Reviews
DOI:
For citation: Babenko S.I., Titov D.A., Mironenko M.Yu., Dontsova V.I., Kazumyan B.V. Right ventricular systolic function in severe functional tricuspid regurgitation: predictive value of longitudinal strain. Creative Cardiology. 2023; 17 (3): 341–9 (in Russ.). DOI: 10.24022/1997-3187-2023-17-3-341-349
Received / Accepted: 25.08.2023 / 28.09.2023
Keywords: echocardiography prognosis tricuspid valve insufficiency right ventricular function, free wall longitudinal strain
Abstract
Functional tricuspid insufficiency is quite common in echocardiographic examination of patients, especially with the pathology of the valves of the left chambers of the heart. Despite the generally accepted opinion that right ventricular dysfunction affects the long-term prognosis, it is still unknown which echocardiographic parameters most accurately reflect the prospect for determining timely tactics, including surgical treatment. Functional tricuspid insufficiency is quite common in echocardiographic examination, especially in patients with pathology of the left heart valves. Echocardiography remains the main method used to study the function and structure of the right ventricle. However, estimating these parameters remains a challenge due to its complex geometry. In the proposed literature review, we tried to describe the parameters of the function of the right ventricle, which, according to foreign authors, can allow the most objective assessment of the state of the right ventricle to select the optimal treatment tactics. Despite the generally accepted opinion that right ventricular dysfunction affects the long-term prognosis, it is still unknown which echocardiographic parameters most accurately reflect the prospect for determining timely tactics, including surgical treatment. Currently, to assess systolic function of the right ventricle, the most commonly used indicators of two-dimensional (2D) echocardiography, such as systolic excursion in the plane of the tricuspid annulus (TAPSE) and changes in fractional area of right ventricle (RVFAC). Three-dimensional (3D) echocardiography allows you to accurately estimate the ejection fraction of the right ventricle, but remains insufficiently widely used due to the need for special software. Two-dimensional echocardiography with myocardial deformity study (2D-STE) was developed, as a method for quantifying the function of the right ventricle, which is practically doesn’t depend on geometry of the structure. It is possible that the use of the new method will complement the system for assessing the state of the right ventricle when choosing tactics for the treatment of functional tricuspid insufficiency.References
- Höke U., Auger D., Thijssen J., Wolterbeek R., van der Velde E.T., Holman E.R. et al. Significant lead-induced tricuspid regurgitation is associated with poor prognosis at long-term follow-up. Heart. 2014; 100 (12): 960–8. DOI: 10.1136/heartjnl-2013-304673
- Prihadi E.A., Delgado V., Leon M.B., Enriquez-Sarano M., Topilsky Y., Bax J.J. Morphologic types of tricuspid regurgitation: characteristics and prognostic implications. JACC: Cardiovasc. Imaging. 2019; 12 (3): 491–9. DOI: 10.1016/j.jcmg.2018.09.027
- Essayagh B., Antoine C., Benfari G., Maalouf J., Michelena H.I., Crestanello J.A. et al. Functional tricuspid regurgitation of degenerative mitral valve disease: a crucial determinant of survival. Eur. Heart J. 2020; 41 (20): 1918–29. DOI: 10.1093/eurheartj/ehaa192
- Wang N., Fulcher J., Abeysuriya N., McGrady M., Wilcox I., Celermajer D. et al. Тricuspid regurgitation is associated with increased mortality independent of pulmonary pressures and right heart failure: a systematic review and meta-analysis. Eur. Heart J. 2019; 40 (5): 476–84. DOI: 10.1093/eurheartj/ehy641
- Iacoviello M., Citarelli G., Antoncecchi V., Romito R., Monitillo F., Leone M. et al. Right ventricular longitudinal strain measures independently predict chronic heart failure mortality. Echocardiography. 2016; 33: 992–1000. DOI: 10.1111/echo.13199
- Liu X.Y., Sun Y. Research progresses of echocardiography in evaluation of right heart structure and function in heart failure with preserved ejection fraction patients. Chin. J. Med. 2020; 36: 614–7.
- Utsunomiya H., Harada Y., Susawa H., Ueda Y., Izumi K., Itakura K. et al. Tricuspid valve geometry and right heart remodelling: insights into the mechanism of atrial functional tricuspid regurgitation. Eur. Heart J. 2020; 21 (10): 1068–78. DOI: 10.1093/ehjci/jeaa194
- Kim M., Lee H.‐J., Park J.‐B., Kim J., Lee S.‐P., Kim Y.‐J. et al. Preoperative right ventricular free‐wall longitudinal strain as a prognosticator in isolated surgery for severe functional tricuspid regurgitation. J. Am. Heart Assoc. 2021; 10 (12): e020842. DOI: 10.1161/JAHA.120.019856
- Zornoff L.A.M., Skali H., Pfeffer M.A., St. John Sutton M., Rouleau J.L., Lamas G.A. et al. Right ventricular dysfunction and risk of heart failure and mortality after myocardial infarction. J. Am. Coll. Cardiol. 2022; 39 (9): 1450–5. DOI: 10.1016/s0735-1097(02)01804-1
- Hyue Mee Kim, Goo-Yeong Cho, In-Chang Hwang, Hong-Mi Choi, Jun-Bean Park, Yeonyee E. Yoon and Hyung-Kwan Kim. Myocardial strain in prediction of outcomes after surgery for severe mitral regurgitation. J. Am. Coll. Cardiol. 2018; 11 (9): 1235–44. DOI: 10.1016/j.jcmg.2018.03.016
- Delgado V., Ypenburg C., van Bommel R.J., Tops L.F., Mollema S.A., Marsan N.A. Assessment of left ventricular dyssynchrony by speckle tracking strain imaging comparison between longitudinal, circumferential, and radial strain in cardiac resynchronization therapy. J. Am. Coll. Cardiol. 2008; 51 (20): 1944–52. DOI: 10.1016/j.jacc.2008.02.040
- Prihadi E.A., van der Bijl P., Dietz M., Abou R., Vollema E.M., Marsan N.A., Delgadoу V. Рrognostic implications of right ventricular free wall longitudinal strain in patients with significant functional tricuspid regurgitation. Circ. Cardiovasc. Imaging. 2019; 12 (3): e008666. DOI: 10.1161/CIRCIMAGING.118.008666
- Bannehr M., Kahn U., Liebchen J., Kropf S., Haase-Fielitz A., Butter Ch. Right ventricular longitudinal strain predicts survival in patients with functional tricuspid regurgitation. Can. J. Cardiol. 2021; 37 (7): 1086–93. DOI: 10.1016/j.cjca.2021.01.006
- Longobardo L., Suma V., Jain R., Carerj S., Zito C., Zwicke D.L., Khandheria B.K. Role of two-dimensional speckle-tracking echocardiography strain in the assessment of right ventricular systolic function and comparison with conventional parameters. J. Am. Soc. Echocardiogr. 2017; 30 (10): 937–46. DOI: 10.1016/j. echo.2017.06.016
- Smolarek D., Gruchała M., Sobiczewski W. Echocardiographic evaluation of right ventricular systolic function: the traditional and innovative approach. Cardiol. J. 2017; 24 (5): 563–72. DOI: 10.5603/CJ.a2017.0051
- Focardi M., Cameli M., Carbone S.F., Massoni A., De Vito R., LisiM., Mondillo S. Traditional and innovative echocardiographic parameters for the analysis of right ventricular performance in comparison with cardiac magnetic resonance. Eur. Heart J. Cardiovasc. Imaging. 2015; 16 (1): 47–52. DOI: 10.1093/ehjci/jeu156
- Ji M., Wu W., He L., Gao L., Zhang Y., Lin Y. et al. Right ventricular longitudinal strain in patients with heart failure. Diagnostics. 2022; 12 (2): 445. DOI: 10.3390/diagnostics12020445
- Rong L.Q., Yum B., Abouzeid Ch., Palumbo M.Ch., Brouwer L.R., Devereux R.B. et al. Echocardiographic predictors of intraoperative right ventricular dysfunction: a 2D and speckle tracking echocardiography study. Cardiovasc. Ultrasound. 2019; 17: 11. DOI: 10.1186/s12947-019-0161-3
- Vahanian A., Beyersdorf F., Praz F., Milojevic M., Baldus S., Bauersachs J. et al. ESC/EACTS Guidelines for the management of valvular heart disease. Eur. Heart J. 2022; 43 (7): 561–632. DOI: 10.1093/eurheartj/ehab395
About Authors
- Svetlana I. Babenko, Dr. Med. Sci., Cardiologist; ORCID
- Dmitriy A. Titov, Cand. Med. Sci., Chief of Department, Cardiovascular Surgeon; ORCID
- Marina Yu. Mironenko, Cand. Med. Sci., Chief of Department, Ultrasound Diagnostician; ORCID
- Vera I. Dontsova, Cand. Med. Sci., Ultrasound Diagnostician; ORCID
- Bagrat V. Kazumyan, Cand. Med. Sci., Cardiovascular Surgeon; ORCID