الفهرس 
The Right VentricleOnly 14 pages are availabe for public view
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Abstract
Cor pulmonale is a common type of heart disease, as a result of its close
association with COPD which has emerged, in recent years, as a leading cause of
disability and death (180). chronic cor pulmonale involves the enlargement of the right
ventricle as a result of pulmonary hypertension due to pulmonary disorders involving the
lung parenchyma, bellows function, or ventilatory drive. chronic Obstructive Pulmonary
Disease (COPD), Interstitial Lung Disease (ILD), and Obstructive Sleep Apnoea (OSA)
are most frequently the underlying lung diseases(139).
The right ventricular hypertrophy that occurs in chronic cor pulmonale is a direct
result of chronic hypoxic pulmonary vasoconstriction and subsequent pulmonary artery
hypertension, leading to increased right ventricular work and stress(181)
Recent recognition of the right ventricle (RV) as a key player in cardiac
physiology and pathophysiology underpins the critical importance of an accurate
assessment of its size, geometry, and function. The presence of RV systolic dysfunction
is an independent prognostic marker of several cardiovascular diseases(182)
While Cardiac MRI is the standard accurate tool in the assessment of RV structure
and function, Echocardiography is the mainstay of assessment of RV structure and
function in clinical practice. RV has a complex anatomy and different systolic motion, so
echocardiographic measurement of RV systolic function is challenging in routine
echocardiographic examination(17)
Recent advances in echocardiography have allowed quantification of regional and
global myocardial function. Regional deformation and deformation rate using DTI and
2D-STE can provide quantitative information on regional myocardial dysfunction(183).
2D-STE, which can quantify complex cardiac motion based on frame to frame tracking
of ultrasonic speckles in grayscale images, has the advantage that it is angle-independent
and shows less preload dependency compared with DTI in the clinical setting(184). Thus,
providing valuable information about myocardial mechanics, systolic and diastolic
functions, ischemia and many other pathophysiological aspects of the heart.
This study aims to assess the right ventricular (RV) function in patients with cor
pulmonale using STE, TDI and conventional echocardiography.
Fifty patients with cor pulmonale compared to twenty age and sex matched
controls selected for echocardiographic examination for assessment of conventional RV
indices (TAPSE, FAC %, RVEED, PASP), TDI, Strain and Strain rate of RV free wall in
addition to conventional left ventricular data
from the present study the following were concluded:
The global and segmental RV free wall peak systolic longitudinal strain (ε sys %) were
significantly impaired in pateints.
The RV free wall systolic strain rate (SR s), early diastolic strain rate (SR e) and late
diastolic strain rate (SR a) were significantly impaired in pateints compared to
controls.
Parameters of RV systolic function (PASP, TAPSE, FAC %, S’) were all significantly impaired in pateints group.
Impaired RV diastolic function parameters (E/A, E’/A’, E/E’) in patients compared to controls.
LV parameters shows no significant difference between patients and the controls
except for LV diastolic function.
Strong Significant correlations as follow; PASP has statistically significant Negative
correlations with TAPSE and RV FAC while Longitudinal Strain was negatively
correlated with PASP and positively correlated with both TAPSE, RV FAC and
Tricuspid annular systolic velocity (S’).
from the previous results, we can say that Speckle Tracking Echocardiography;
Strain and Strain Rate are a reliable means of measuring global RV function because it
correlates well with other more established measurements of global RV systolic function
(i.e. TAPSE and RV FAC). Furthermore, regional RV systolic strain and strain rate make
it possible to study regional RV function, can be used as an index of RV function in
patients with cor pulmonale and of great diagnostic values and help for identification
patients with subclinical RV dysfunction, thus this novel technique is expected to have
clinical implications for better management of such patients.