Right ventricular (RV) dysfunction is a prognostic factor for cardiovascular disease (CVD). However, its pathophysiology and mechanism remain unknown. In this study, the RV function was assessed using RV‐specific 3‐dimensional (3D)‐speckle‐tracking echocardiography (STE) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). The chronological changes during balloon pulmonary angioplasty (BPA), and regional wall motion abnormalities in the RV were also assessed.

Twenty‐nine patients with CTEPH who underwent BPA were enlisted and received right heart echocardiography and catheterization previously, immediately afterward, and six months after BPA. The echocardiographic examination of the RV function included both RV‐specific 3D‐STE and 2‐dimensional‐STE. Prior to BPA, the global area change ratio measured by 3D‐STE was significantly associated with invasively measured mean pulmonary vascular resistance and pulmonary artery pressure. The outlet area change ratio was significantly associated with troponin T values at six months after BPA, and its improvement after BPA was delayed compared with the inlet and apex regions.

The RV‐specific 3D‐STE analysis revealed that 3D right ventricular parameters were functional indicators for evaluating hemodynamics, and RV function in pulmonary hypertension. Each regional RV portion presents a unique response to hemodynamic changes during treatment, implicating that RV local functions’ evaluation might lead to a new guide for treatment strategies.

Ref: https://www.ahajournals.org/doi/10.1161/JAHA.120.018096