Value of three-dimensional speckle tracking echocardiography to assessment of right ventricular myocardial fibrosis in patients with end-stage heart failure due to dilated cardiomyopathy
FAN Kejun
DONG Wenjuan
YUE Linkun
Abstract：Objective To investigate the value of three-dimensional speckle tracking echocardiography(3D-STE)to assessment of right ventricular myocardial fibrosis in patients with end-stage heart failure(HF)due to dilated cardiomyopathy(DCM).Methods The patients with end-stage HF due to DCM(n=122)were selected from Central Hospital of Yuncheng City affiliated to Shanxi Medical University from Jan.2019 to June 2024.According to cardiac magnetic resonance results,the patients were divided into fibrosis group(n=85)and non-fibrosis group(n=37).All patients were given right heart catheterization to detect systolic pulmonary arterial pressure(sPAP),diastolic pulmonary arterial pressure(dPAP),right atrial pressure,pulmonary artery wedge pressure(PAWP),transpulmonary pressure gradient and pulmonary vascular resistance(PVR),and 3D-STE examination to calculate right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),right ventricular stroke volume(RVSV),right ventricular ejection fraction(RVEF)and three-dimensional right ventricular free wall longitudinal strain(3D-RVFWSL).The clinical value of 3D-STE parameters to myocardial fibrosis was assessed by using receiver operating characteristic(ROC)curve,and the influence factors for myocardial fibrosis were investigated by uing binary Logistic stepwise regression analysis in patients with end-stage HF due to DCM.Results RVEDV and RVESV were higher,and RVSV,RVEF and 3D-RVFWLS were lower in fibrosis group than those in non-fibrosis group(P<0.05).In assessment of myocardial fibrosis,AUC of RVEDV was 0.649(95%CI:0.604～0.694),AUC of RVESV was 0.736(95%CI:0.686～0.781),AUC of RVSV was 0.819(95%CI:0.774～0.869),AUC of RVEF was 0.853(95%CI:0.803～0.903),and AUC of 3D-RVFWLS was 0.934(95%CI:0.889-0.984).The number of patients with history of hypertension and diabetes were more in fibrosis group than that in non-fibrosis group(P<0.05).The results of multi-factor Logistic analysis showed that diabetes(OR=1.992,95%CI:1.119～3.544),RVEDV(OR=2.147,95%CI:1.305-3.532),RVESV(OR=2.442,95%CI:1.315～4.537),RVSV(OR=2.601,95%CI:1.240～5.457),RVEF(OR=2.838,95%CI:1.561-5.159)and 3D-RVFWLS(OR=3.089,95%CI:1.750～5.454)were influence factors for myocardial fibrosis in patients with end-stage HF due to DCM(P<0.05).Conclusion 3D-STE has clinical value and is an effective tool in assessment of myocardial fibrosis in patients with end-stage HF due to DCM.
Keywords：ultrasound three-dimensional speckle tracking technologydilated cardiomyopathyheart failuremyocardial fibrosisclinical value
Publication Date：2025-12-20
Online Publishing Date：2026-03-25(First online date of this platform, not the publication date of the document)
Pages：6( 1501-1506 )