Evaluación de la deformación longitudinal global y segmentaria del ventrículo derecho con ecocardiografía bidimensional speckle-tracking con la elevación de las piernas

Speckle-tracking echocardiography has shown its usefulness in the evaluation of the right ventricle (RV) in healthy subjects and in pulmonary hypertension. It is unknown whether this technique could be sensitive to assess healthy RV with increases in preload.Consecutive subjects were studied without evidence of cardiopulmonary disease. They underwent speckle-tracking echocardiography in General Electric Vivid 7® equipment. The "segmental longitudinal strain" (SLS) and "global longitudinal strain" (GLS) of the RV was determined at rest and with an increase in the preload through elevation the legs to 45°.We analyzed 31 subjects, 16 men and 15 women, aged 16-53 years, in which were measured SLS and GLS. Basal of the RV free wall: -29.1 ± 3.3 versus -32.7 ± 5.5%, p = 0.0002. Mid of the RV free wall: -28.6 ± 6.4 versus -31.5 ± 4.9%, p = 0.001. Apical of the free wall of the RV: -21.9 ± 6.5 versus -23.3 ± 6.1%, p = 0.118. Basal inferoseptum: -19.40 ± 3.2 versus -18.9 ± 3.0%, p = 0.204. Mid inferoseptum: -19.3 ± 3.2 versus -19 ± 3.1%, p = 0.249. Apical septum: -17.1 ± 5.1 versus -17 ± 5.4%, p = 0.457. GLS of the RV: -23.06 ± 3.4 versus -24.5 ± 2.9%, p = 0.002. ICC: 0.773, 95% CI: 0.534-0.890, p < 0.001.This method was sensitive to detect differences in the GLS and SLS basal and mid of the RV free wall.La ecocardiografía speckle-tracking (EST) ha mostrado su utilidad en la evaluación del ventrículo derecho (VD) en sujetos sanos y en hipertensión pulmonar. Se desconoce si esta técnica es sensible para evaluar el VD en sujetos sanos con aumento en la precarga.Se evaluaron sujetos consecutivos sin evidencia de enfermedad cardiopulmonar. Se realizó EST con equipo General Electric Vivid 7®. La deformación longitudinal segmentaria (DLS) y la deformación longitudinal global (DLG) del VD se determinaron en reposo y con incremento en la precarga mediante la elevación de las piernas a 45°.Analizamos 31 sujetos, 16 hombres y 15 mujeres. Edad: 16-53 años. Basal de la pared libre del VD: –29.1 ± 3.3 vs. –32.7 ± 5.5%, p = 0.0002. Medio de la pared libre del VD: –28.6 ± 6.4 vs. –31.5 ± 4.9%, p = 0.001. Apical de la pared libre del VD: –21.9 ± 6.5 vs. –23.3 ± 6.1, p = 0.118. Basal septum inferior: –19.40 ± 3.2 vs. –18.9 ± 3.0%, p = 0.204. Medio septum inferior: –19.3 ± 3.2 vs. –19 ± 3.1%, p = 0.249. Apical septal −17.1% ± 5.1 vs. −17 ± 5.4, p = 0.457. DLG del VD: –23.06 ± 3.4 vs. –24.5 ± 2.9%, p = 0.002. CCI: 0.773, IC 95%: 0.534-0.890, p < 0.001.El método fue sensible para detectar diferencias en la DLG y DLS basal y media de la pared libre del VD.