Dominance of free wall radial motion in global right ventricular function of heart transplant recipients

Assessment of right ventricular (RV) function using conventional echocardiography might be inadequate as the radial motion of the RV free wall is often neglected. Our aim was to quantify the longitudinal and the radial components of RV function using three-dimensional (3D) echocardiography in heart transplant (HTX) recipients. 51 HTX patients in stable cardiovascular condition without history of relevant rejection episode or chronic allograft vasculopathy and 30 healthy volunteers were enrolled. RV end-diastolic (EDV) volume and total ejection fraction (TEF) were measured by 3D echocardiography. Furthermore, we quantified longitudinal (LEF) and radial ejection fraction (REF) by decomposing the motion of the RV using the ReVISION method. RV EDV did not differ between groups (HTX vs. control; 96+/-27 vs. 97+/-2 ml). In HTX patients TEF was lower, however, tricuspid annular plane systolic excursion (TAPSE) decreased to a greater extent (TEF: 47+/-7 vs 54+/-4% [-13%], TAPSE: 11+/-5 vs 21+/-4 mm [-48%], p<0.0001). In HTX patients, REF/TEF ratio was significantly higher compared to LEF/TEF (REF/TEF vs. LEF/TEF: 0.58+/-0.10 vs. 0.27+/-0.08, p