Echocardiographic assessment of regional right ventricular function: A head-to-head comparison between 2-dimensional and tissue Doppler-derived strain analysis

Objective: We sought to compare the feasibility and results of Doppler tissue imaging-derived and 2-dimensional strain echocardiography-derived deformation assessment of the right ventricular (RV) free wall. Methods: Absolute values and timing of strain and strain rate (SR) obtained by both techniques in the basal, mid, and apical segments of the RV free wall were prospectively analyzed and compared in individuals with varying RV function and geometry: patients with an impaired RV function (n = 23), endurance athletes (n 22), and control subjects (n = 22). Results: Both techniques yielded a 93% technical feasibility and had a similar interobserver and intraobserver variability. The overall correlation for onset strain values was 0.59, with better correlation in the pathologic RV (r = 0.77). The overall correlation of peak strain was moderately good for strain values (r = 0.73) and timing (r = 0.56). Over the entire range of systolic and diastolic values, SR correlated closely (r = 0.90). Systolic SR correlated moderately (r = 0.59), but its timing poorly (r = 0.35). There was a small bias toward higher values of strain and SR when using Doppler tissue imaging, except in the basal segment. Conclusion: Overall, in the assessment of RV deformation, Doppler tissue imaging and 2-dimensional strain echocardiography correlate moderately well and display a comparable feasibility.