• Tomás F Cianciulli, Omar Prieto, Alejandro Stewart-Harris, Andrea S Rodríguez, María Cristina Saccheri, and Juan Alberto Gagliardi.
• Departmento de Cardiología, Hospital General de Agudos Dr Cosme Argerich, Buenos Aires, Argentina. E-mail: tcianciulli@gmail.com.
• Medicina (B Aires). 2023 Jan 1; 83 (1): 192819-28.

UnlabelledRight ventricular longitudinal strain (RVLS) is frequently used as a measure of right ventricular systolic function. Abnormal RV strain is associated with poor prognosis in patients with pulmonary hypertension (PH); however, the measure is not always easy to obtain in patients with poor apical acoustic windows.ObjectiveThis study aims to analyze the RVLS and determine if there is a difference when measured from the apical and subcostal views.MethodsIn this cross-sectional study, we analyzed 22 adult outpatients (= 18 years old), 81% female, mean age 49.9 ± 17.3 years, with a diagnosis of PH using right heart catheterization, followed from January 2016 to January 2020.ResultsRVLS measured in the RV free wall from the apical views was -15% (-19% to -10%) and subcostal views -14.5% (-18% to -11%) were highly correlated (Person's r = 0.969, p < 0.0001). Segment by segment analysis did not show significant differences either: basal four-chamber vs. subcostal view was -16.5% (-21% to -11%) vs. -15.5% (-20% to -11%), p = 0.99, mid four-chamber view vs. subcotal view was -16.5% (-21% to -12%) vs. -16.5% (-20% to -11%), p = 0.87, apical four-chamber view vs. subcostal view was -12% (-18% to -8%) vs. -13.5% (-19% to -10%), p = 0.93.ConclusionSubcostal RVLS free wall is a feasible and accurate alternative to conventional RVLS free wall from the apical view in patients with pulmonary hypertension and could be useful in patients with poor acoustic apical four-chamber windows.

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