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Abstract Cor pulmonale is a common type of heart disease, as a result of its close association with COPD which has emerged, in recent years, as a leading cause of disability and death (180). chronic cor pulmonale involves the enlargement of the right ventricle as a result of pulmonary hypertension due to pulmonary disorders involving the lung parenchyma, bellows function, or ventilatory drive. chronic Obstructive Pulmonary Disease (COPD), Interstitial Lung Disease (ILD), and Obstructive Sleep Apnoea (OSA) are most frequently the underlying lung diseases(139). The right ventricular hypertrophy that occurs in chronic cor pulmonale is a direct result of chronic hypoxic pulmonary vasoconstriction and subsequent pulmonary artery hypertension, leading to increased right ventricular work and stress(181) Recent recognition of the right ventricle (RV) as a key player in cardiac physiology and pathophysiology underpins the critical importance of an accurate assessment of its size, geometry, and function. The presence of RV systolic dysfunction is an independent prognostic marker of several cardiovascular diseases(182) While Cardiac MRI is the standard accurate tool in the assessment of RV structure and function, Echocardiography is the mainstay of assessment of RV structure and function in clinical practice. RV has a complex anatomy and different systolic motion, so echocardiographic measurement of RV systolic function is challenging in routine echocardiographic examination(17) Recent advances in echocardiography have allowed quantification of regional and global myocardial function. Regional deformation and deformation rate using DTI and 2D-STE can provide quantitative information on regional myocardial dysfunction(183). 2D-STE, which can quantify complex cardiac motion based on frame to frame tracking of ultrasonic speckles in grayscale images, has the advantage that it is angle-independent and shows less preload dependency compared with DTI in the clinical setting(184). Thus, providing valuable information about myocardial mechanics, systolic and diastolic functions, ischemia and many other pathophysiological aspects of the heart. This study aims to assess the right ventricular (RV) function in patients with cor pulmonale using STE, TDI and conventional echocardiography. Fifty patients with cor pulmonale compared to twenty age and sex matched controls selected for echocardiographic examination for assessment of conventional RV indices (TAPSE, FAC %, RVEED, PASP), TDI, Strain and Strain rate of RV free wall in addition to conventional left ventricular data from the present study the following were concluded: The global and segmental RV free wall peak systolic longitudinal strain (ε sys %) were significantly impaired in pateints. The RV free wall systolic strain rate (SR s), early diastolic strain rate (SR e) and late diastolic strain rate (SR a) were significantly impaired in pateints compared to controls. Parameters of RV systolic function (PASP, TAPSE, FAC %, S’) were all significantly impaired in pateints group. Impaired RV diastolic function parameters (E/A, E’/A’, E/E’) in patients compared to controls. LV parameters shows no significant difference between patients and the controls except for LV diastolic function. Strong Significant correlations as follow; PASP has statistically significant Negative correlations with TAPSE and RV FAC while Longitudinal Strain was negatively correlated with PASP and positively correlated with both TAPSE, RV FAC and Tricuspid annular systolic velocity (S’). from the previous results, we can say that Speckle Tracking Echocardiography; Strain and Strain Rate are a reliable means of measuring global RV function because it correlates well with other more established measurements of global RV systolic function (i.e. TAPSE and RV FAC). Furthermore, regional RV systolic strain and strain rate make it possible to study regional RV function, can be used as an index of RV function in patients with cor pulmonale and of great diagnostic values and help for identification patients with subclinical RV dysfunction, thus this novel technique is expected to have clinical implications for better management of such patients. |