Geert Kleinnibbelink

Chapter 3 72 first 5% of volume ejection in systole (ESslope), (b) the overall linear slope during systole (Sslope) and (c) end-systolic peak global longitudinal strain (peak strain). In addition (un) coupling was termed to describe the relationship between systolic and diastolic strain for any given area/volume. By subtracting diastolic from systolic strain, the difference at any given area/volumewas calculated. Uncouplingwas assessed as themeanof the differences during (d) early diastole (early 2/3 of diastole [Uncoupling ED]), (e) late diastole (late 1/3 of diastole [Uncoupling LD]) and (f ) overall (complete cardiac cycle). Furthermore, (g) the early linear slope during first 5% (EDslope) and (h) late linear slope (LDslope) during last 5% of volume increase in diastole. RV area (cm 2 ) RV longitudinal strain (%) ESA EDA a. EarlySslope b. Sslope c. Peak strain d. Uncoupling EarlyD e. Uncoupling LateD f. Uncoupling g. EarlyDslope h. LateDslope 0 0 -21 a b c e d 100% of EDA 40% of EDA 25 f g h Figure 2 . Schematic overview of the RV strain-area loop and the derived characteristics. The black line represents the strain-area loop; the thick part represents the systolic phase and the thin part the systolic phase. ED, End-diastolic, EDA, end-diastolic area; ESA, end-systolic area; LD, late diastolic. In order to obtain intra-observer variability, 10 randomly selected echocardiograms were re-analyzed. Intra-class correlation coefficient (ICC) analysis was performed for the following measures: RV strain-area loop characteristics, RVEDA, RVESA, RVFAC, RV basal diameter, RV mid-cavity diameter, RVOT PLAX, RA area, IVSd, PWd, LVIDd.