Speckle-tracking echocardiographic evaluation of the right ventricle in patients with ischemic left ventricular dysfunction

Background: The comprehensive assessment of right ventricular (RV) performance is of paramountimportance because it is has been recognized as a strong prognostic factor in a variety of clinical settings.The aim herein was to evaluate the usefulness of RV longitudinal strain imaging by speckle-trackingechocardiography (STE) in daily clinical practice, especially in the context of RV systolic function andits changes after acute coronary syndrome (ACS).Methods: This prospective study enrolled 63 patients with ischemic injury (left ventricular ejectionfraction [LVEF] ≤ 45%). Additionally, a subgroup was created: patients with ACS treated with successfulpercutaneous coronary intervention. The clinical and echocardiographic parameters, includingSTE, were analyzed.Results: Significant correlations for both RV free-wall (RVFWSL) and four-chamber (RV4CSL) longitudinalstrain evaluated by STE with New York Heart Association class, LVEF, E/E’ ratio, as well asconventional parameters of RV function were found. RVFWSL was able to detect subtle RV functionalabnormalities, unreachable for traditional indices. RV recovery after ACS was not related to higherLVEF but better contractility of the interventricular septum (IVS) assessed by STE.Conclusions: Right ventricular strain proved to be a useful two-dimensional echocardiographicmethod to detect impaired RV performance, which showed a significant relationship with clinical andother echocardiographic indices. The IVS played a vital role in RV recovery among ACS survivors