الفهرس 
Patients and MethodsOnly 14 pages are availabe for public view
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Abstract
Dilated cardiomyopathy (DCM) is characterized by dilatation and impaired contraction of one or both ventricles. This can be pregressive causing advanced heart failure. Also, in dilated cardiomyopathy (DCM), right ventricular (RV) dysfunction has been reported to attribute to both altered loading conditions and to involvement in the myopathic process. For this reason, the assessment of RV function in patients with DCM is important. Aim of study: Our study aim was to detect RV myocardial dysfunction in patients with DCM using two-dimensional (2D) strain echocardiography and its relation to left ventricular dysfunction in both ischaemic and idiopathic causes of DCM. Methodology: The present study included 50 patients with impaired left ventricular ejection fraction grouped into 25 patients with ICM, 25 patients with DCM and 15 age matched subjects served as control.
Participants in the study were subjected to full history taking, through clinical examination, 12 leads ECG.
2D echocardiography, M-mode and Doppler examination were performed; LV dimensions were measured including LVEDD, LVESD, IVSD, LVPWD, and left ventricular ejection fraction. Pulsed-wave Doppler echocardiography was performed for measuring mitral inflow velocities, TAPSI, Tricuspid annular TDI were performed.
Strain and strain rate parameters were measured by using GE Vivid 9 echocardiography machine, through an off line analysis by using 2 D Speckle tracking imaging, we measured left & right ventricular global and regional peak systolic strain, global and regional peak systolic strain rate, global and regional early diastolic strain rate and global and regional late diastolic strain rate. Results Results showed RV systolic & diastolic dysfunction at both global & regional levels in patients with dilated cardiomyopathy in both ischaemic and idiopathic groups. Also, a significant difference between the DCM & ICM groups with impairement of peak longtuidinal RV systolic strain values in DCM group more than in ICM group Correlation done between the values of the RV global peak systolic longitudinal strain & RV global strain rate was done with TAPSE, showed a negative significant difference with both parameters. Also, TAPSE showed non-significant difference in comparing between ICM & DCM groups by conventional 2D echocardiography. Conclusions: Evidence of deterioration of RV mechanics in dilated cardiomyopathy was found to be a significant feature. Application of speckle tracking in DCM offers incremental information in this complex cardiomyopathy beyond clinical and conventional echocardiographic parameters. So, application of 2D strain to routine grayscale 2D images is recommended & represents a promising noninvasive technique for assessment of RV myocardial dysfunction in patients with DCM.