Abstract
Introduction
During acute respiratory failure (ARF), right ventricular (RV) function can be abnormal due to increased afterload and/or decreased contractility or preload. Speckle tracking strain analysis can diagnose RV dyssynchrony. We aimed to test whether RV dyssynchrony exists during ARF and can be reversed during non-invasive ventilation (NIV).
Methods
Prospective study including 13 patients admitted for ARF. Trans thoracic echocardiography (TTE) was performed during spontaneous breathing (SB) activity and during NIV. Usual echo parameters and speckle tracking strain were measured. The software generated 6 segmental RV strain curves. Time to peak strain from each of 6 time-strain curves was determined with dyssynchrony defined as the difference between earliest and latest segments.
Results
13 patients aged 69(11) y were included. 11 had chronic respiratory failure. Compared to SB, left ventricular ejection fraction and stroke volume increased during NIV: 59 (6) vs 66 (6) %, 61 (9) vs 65 (11) mL, p < 0.05 respectively, and systolic pulmonary arterial pressure (SPAP) decreased 61 (16) mmHg vs 41(16) mmHg, p = 0.03. RV dyssynchrony improved significantly: 235(140) vs 182 (149) msec, p =0.04.
Conclusion
RV dyssynchrony measured using speckle tracking strain is observed in our ARF patients. NIV can improve LVEF, RV afterload and RV dyssynchrony.
- © 2012 ERS
