The following is a summary of “Right ventricular pressure-strain relationship-derived myocardial work reflects contractility: validation with invasive pressure-volume analysis,” published in the March 2024 issue of Pulmonology by Lakatos et al.

Three-dimensional (3D) echocardiography has provided valuable insights into assessing right ventricular (RV) function, with parameters such as RV ejection fraction (EF) and global longitudinal strain (GLS) commonly used. However, these measures are known to be influenced by loading conditions, limiting their reliability as indicators of true RV contractility. Global myocardial work index (GMWI) offers a promising alternative, calculated by integrating myocardial deformation with instantaneous pressure, thus potentially reflecting contractility more accurately. To investigate this hypothesis, researchers conducted a study involving 60 patients undergoing RV pressure-conductance catheterization to establish load-independent markers of RV contractility and ventriculo-arterial coupling. 

Detailed 3D echocardiography was also performed to evaluate RV EF, RV GLS, and GMWI derived from the RV pressure-strain loop. Their findings revealed that while RV EF and GLS failed to correlate with end-systolic elastance (Ees), a key measure of contractility, GMWI demonstrated a strong association with Ees. RV EF and GLS also exhibited a relationship with the Ees/Ea ratio, indicating ventriculo-arterial coupling. Moreover, subgroup analysis based on risk classification using the Reveal Lite 2 system unveiled distinct characteristics among different risk groups. 

These results suggest that RV GMWI holds promise as a clinically useful tool for risk stratification and long-term monitoring in patients with RV dysfunction, offering insights into contractile function beyond conventional measures such as RV EF and GLS.

Source: sciencedirect.com/science/article/pii/S1053249824015328