Effects of age and gender on right ventricular systolic and diastolic function using two-dimensional speckle-tracking strain

Abstract

Background: Accurate assessment of the right ventricle is increasingly important. Measures of right ventricular (RV) systolic function, including fractional area change, tissue Doppler (s' velocity), and tricuspid annular plane systolic excursion, show significant variation, and the impacts of age and gender are unclear. The aim of this study was to determine the effects of gender and age on global and segmental RV systolic and diastolic function using both traditional echocardiographic and two-dimensional strain parameters.

Methods: Detailed transthoracic echocardiographic studies were performed on 142 healthy adult volunteers, with particular emphasis on the right ventricle to determine RV dimensions and function, including fractional area change, tricuspid annular plane systolic excursion, s' velocity, global and segmental systolic strain, and systolic, early diastolic, and late diastolic strain rates.

Results: Tricuspid annular plane systolic excursion (r = -0.4, P < .001) and RV s' velocity (r = -0.5, P < .001) as well as diastolic functional parameters, including transtricuspid peak E velocity and RV free wall e' velocity (r = -0.4, P < .001), decreased with age. Global systolic strain was also reduced, with differential reductions in basal and mid segmental strain with age. Early diastolic strain rate decreased, with a corresponding increase in late diastolic strain rate. RV function parameters, including fractional area change, e' velocity, strain, and strain rate, were significantly lower in men.

Conclusions: RV functional analysis by two-dimensional strain demonstrates a small yet significant change in global and segmental RV function with age and gender, and therefore adjustment for these measures is required in the evaluation of RV function.

Keywords: Age; Gender; Right ventricle; Strain.