Right ventricular outflow tract systolic excursion: a novel echocardiographic parameter of right ventricular function

Abstract

Aims: Right ventricular (RV) function has important prognostic and therapeutic implications. Assessment of RV function using echocardiography is challenging. The aim of this study was to evaluate a new parameter of RV function, right ventricular outflow tract systolic excursion (RVOT_SE).

Methods and results: RVOT_SE was measured using M-Mode echocardiography from the parasternal short-axis view at the level of the aortic valve, and was defined as the systolic excursion of the RVOT anterior wall. RVOT_SE was measured in 50 patients (age 64 ± 18 years, 28 males) with normal RV function [RV fractional area change (FAC) ≥35% and tricuspid annular plane systolic excursion (TAPSE) ≥1.6 cm] and 40 patients (age 68 ± 12 years, 35 males) with reduced RV function (RV FAC <35% and TAPSE <1.6 cm). R.V FAC was 46 ± 7% in the normal RV group and 22 ± 5% in the reduced RV group (P < 0.0001). TAPSE was 2.2 ± 0.4 cm in the normal RV group and 1.0 ± 0.2 cm in the reduced RV group (P < 0.0001). RVOT_SE was 9.6 ± 1.5 mm in the normal RV group and 1.7 ± 1.1 mm in the reduced RV group (P < 0.0001). RVOT_SE <6 mm identified patients with reduced RV function with 100% sensitivity and 100% specificity. Survival at 1 year was 63% in patients with RVOT_SE <6 mm and 84% in patients with RVOT_SE ≥6 mm, P = 0.004.

Conclusion: RVOT_SE is a novel, simple, and promising parameter for assessing RV function, and it is associated with poor survival.