石津 智子¹, 瀬尾 由広², 町野 智子², 山本 昌良², 針村 佳江², 青沼 和隆²

Tomoko ISHIZU¹, Yoshihiro SEO², Tomoko MACHINO-OHTSUKA², Masayoshi YAMAMOTO², Yoshie HARIMURA², Kazutaka AONUMA²

¹筑波大学臨床検査医学, ²筑波大学循環器内科

¹Department of Clinical Laboratory Medicine, University of Tsukuba, ²Cardiovascular Division, University of Tsukuba

キーワード :

【Background】
While right ventricular（RV）systolic dysfunction is associated with the poor prognosis, the accurate assessments of global RV function at bedside is still difficult.
【Method and Results】
Among 144 subjects who underwent RV 3D echocardiography assessment, 90（63％）subjects（20 with pulmonary arterial hypertension, 22 with congenital heart disease, 24 dilated cardiomyopathy, and 24 normal subjects）with sufficient 3D image quality were included. Remaining 54（38％）subjects with the insufficient quality of echo image, mainly in RV outlet, were excluded. Prototype software for RV 3D speckle tracking（Toshiba Medical Systems）was used. In comparison to the RV ejection fraction（EF）, significant correlations（p＜0.001）were observed in following indices; TAPSE（R=0.47）, fractional area change（FAC）（R=0.57）, global area strain（R=-0.82）, global longitudinal strain（R=-0.58）, global circumferential strain（R=-0.52）, but not in tissue Doppler S’of tricuspid annuls. In stepwise methods for RVEF determinants, global area strain was selected as the best indicator, followed by the area strain of RV inlet, and FAC. To diagnose RVEF＜30％，inlet area strain＞-27％showed the greatest area under the curve of 0.89（p＜0.001）in ROC analysis with sensitivity of 80％，specificity of 79％among the all RV indices.
【Conclusion】
Area strain, derived from 3D speckle tracking echocardiography, may be the promising accurate indicator for RVEF among the various echocardiographic parameters.