RV longitudinal strain helps detect myocardial fibrosis in HF patients

An analysis of patients with severe systolic heart failure found that right ventricular free wall longitudinal strain was the most accurate diagnostic tool for detecting myocardial fibrosis. The patients’ right ventricles were significantly enlarged when their systolic function was reduced.

Lead researcher Matteo Lisi, MD, of the Department of Cardiovascular Disease at the University of Siena in Italy, and colleagues published their findings online in the Journal of the American College of Cardiology: Cardiovascular Imaging on April 27.

The study enrolled 27 patients with end-stage heart failure who were referred to a hospital for right heart catheterization and echocardiography before undergoing a heart transplant. They obtained tissue samples of the right ventricular free wall and compared the  echocardiography results with 25 patients who did not have a cardiac condition or history of systemic disease.

The heart failure group had a higher left ventricular mass index, reduced ejection fraction and reduced left ventricular global longitudinal strain compared with the control group.

Researchers said the results suggest that right ventricular free wall longitudinal strain is a useful echocardiographic measure in estimating right ventricular systolic performance and predicting the extent of myocardial fibrosis in this patient population.

They mentioned that limitations of the study included its small number of participants and that the right ventricular free wall longitudinal strain measurements may depend on the vendors that manufacture the devices.