Geert Kleinnibbelink

General Introduction and Outline of Thesis 23 1 speckle tracking echocardiography may overcome some of these limitations ( Figure 5G ). Therefore, this novel technique will be applied in this thesis and further introduced below. The contemporary methods to assess RV function are limited to display peak values only whereas speckle tracking echocardiography has the ability to analyse RV function over time. In order to utilise these technical advances, our group has introduced the strain-area loop which combines structure and function into one echocardiographic measurement and provides the RV structure-function relationship which will be further introduced below ( Figure 5H ). 49 Figure 5 . Diagram representing echocardiographic RV structure (red circles) and function (green) measurements. The black circle (H) represents the novel strain-area loop introduced by our research group. A) RV wall thickness; B) RV linear dimensions; C) RV outflow tract (RVOT) linear dimensions; D) tricuspid annular plane systolic excursion (TAPSE); E) RV fractional area change (RVFAC); F) tissue Doppler imaging (TDI); G) Speckling tracking echocardiography; H) Strain-area loop.