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Reproducibility and feasibility of right ventricular strain and strain rate (SR) as determined by myocardial speckle tracking during high-intensity upright exercise: a comparison with tissue Doppler-derived strain and SR in healthy human hearts

Abstract

This study aimed to establish feasibility for myocardial speckle tracking (MST) and intra-observer reliability of both MST and tissue velocity imaging (TVI)-derived right ventricular (RV) strain (ε) and strain rate (SR) at rest and during upright incremental exercise. RV ε and SR were derived using both techniques in 19 healthy male participants. MST-derived ε and SR were feasible at rest (85% of segments tracked appropriately). Feasibility reduced significantly with progressive exercise intensity (3% of segments tracking appropriately at 90% maximum heart rate (HRmax)). Coefficient of variations (CoVs) of global ε values at rest was acceptable for both TVI and MST (7–12%), with low bias and narrow limits of agreement. Global SR data were less reliable for MST compared with TVI as demonstrated with CoV data (systolic SR=15 and 61%, early diastolic SR=16 and 17% and late diastolic SR=26 and 31% respectively). CoVs of global RV ε and SR obtained at 50% HRmax were acceptable using both techniques. As exercise intensity increased to 70 and 90% HRmax, reliability of ε and SR values reduced with larger variability in MST. We conclude that RV global and regional ε and SR data are feasible, comparable and reliable at rest and at 50% HRmax using both MST and TVI. Reliability was reduced during higher exercise intensities with only TVI acceptable for clinical and scientific use.

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Correspondence to David Oxborough PhD.

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Lord, R.N., George, K., Jones, H. et al. Reproducibility and feasibility of right ventricular strain and strain rate (SR) as determined by myocardial speckle tracking during high-intensity upright exercise: a comparison with tissue Doppler-derived strain and SR in healthy human hearts. Echo Res Pract 1, 31–41 (2014). https://doi.org/10.1530/ERP-14-0011

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  • DOI: https://doi.org/10.1530/ERP-14-0011

Keywords

  • right ventricle
  • exercise echocardiography
  • tissue Doppler and strain echocardiography
  • strain rate imaging