4-dimensional strain imaging of the right ventricle: application in patients with severe pulmonary hypertension

Background The risk stratification of patients with pulmonary hypertension (PHTN) using non-invasive techniques is challenging. 4D analysis techniques of right ventricular (RV) strain may provide unique opportunities for the identification of high-risk individuals. However, conventional strain metrics, developed for left ventricular geometry, pose limitations for RV geometry and its associated fibre orientations. In this study we examine a novel 4D strain analysis tool affording calculation of axis-independent Principal strains for the assessment of right ventricular mechanics. Patients with mild-moderate and severe PHTN were studied in comparison to a young healthy volunteer cohort.