4-dimensional strain imaging of the right ventricle: application in patients with severe pulmonary hypertension
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KeywordsPulmonary Hypertension Right Ventricular Pulmonary Arterial Pressure Cine Image Young Healthy Volunteer
The risk stratification of patients with pulmonary hypertension (PHTN) using non-invasive techniques is challenging. 4D analysis techniques of right ventricular (RV) strain may provide unique opportunities for the identification of high-risk individuals. However, conventional strain metrics, developed for left ventricular geometry, pose limitations for RV geometry and its associated fibre orientations. In this study we examine a novel 4D strain analysis tool affording calculation of axis-independent Principal strains for the assessment of right ventricular mechanics. Patients with mild-moderate and severe PHTN were studied in comparison to a young healthy volunteer cohort.
In this pilot study, we demonstrate the feasibility of 4D Strain analysis using Principal Strains for the characterization of RV mechanical deformation in PHTN. A novel marker, NorStAR, accurately identified patients with invasive hemodynamic evidence of severe versus non-severe PHTN and may be of value for the risk stratification of this population.
This study was funded by the Calgary Health Trust. Dr Satriano receives support from Mitacs Canada and Medtronic of Canada, Ltd. Dr White is supported by a New Investigator Award from the Heart and Stroke Foundation of Alberta.
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