Objective: To explore the feasibility of using two-dimensional speckle tracking echocardiography for measuring right ventricular strain and function in healthy adults, and to analyze the impact of age and gender. Methods: This study is a cross-sectional study. Healthy adults who underwent physical examination in the Physical Examination Center of Beijing Hospital from January 1, 2020 to January 1, 2021 were included. Two researchers independently measured various right ventricular longitudinal strain indices using the Echopac software, including (global longitudinal strain (GLS), apical longitudinal strain (ALS), midventricle longitudinal strain (MLS), basal longitudinal strain (BLS), free wall GLS (FWGLS), free wall ALS (FWALS), free wall MLS (FWMLS) and free wall BLS (FWBLS)) as well as tricuspid annular plane systolic excursion (TAPSE) and right ventricle-fraction of area change (RVFAC). The above indicators were taken as the average of two physicians. The consistency of the measurements by two physicians was evaluated by the within-group correlation coefficient (ICC). Results: A total of 233 subjects were included, including 137 males, aged (58.5±14.2) years. ICC values was all above 0.8 with excellent agreement. The values of FWGLS and GLS in healthy adults were -26.63% and -21.89%, respectively. There was no statistically significant difference in TAPSE ((2.06±0.41)cm vs. (2.10±0.39)cm, P=0.510) and RVFAC ((51.17±9.91)% vs. (50.89±8.65)%, P=0.826) between males and females. The values of various right ventricular long axis strain indicators (GLS, ALS, MLS, BLS, FWGLS, FWMLS, FWMLS, FWBLS) in females aged 18 to 40 and 41 to 65 years were higher than those in males of the same age (all P<0.05), while there was no statistically significant difference in the values of various right ventricular long axis strain indicators between the sexes in subjects aged 65 years and above (all P>0.05). In females, the right ventricular GLS, ALS, MLS, FWGLS, FWALS, FWMLS, and FWBLS values in the groups aged 18 to 40 and 41 to 65 years were significantly higher than those in the group aged 65 years and above (all P<0.05). In contrast, no significant differences were found in these indices among different age groups in males (all P>0.05). Conclusions: Using two-dimensional speckle tracking technology in echocardiography to measure right ventricular strain indicators is feasible and highly reproducible. Gender and age have an impact on right ventricular strain indicators.
目的： 探索超声心动图二维斑点追踪技术测量健康成年人右心室应变及功能的可行性，并分析年龄及性别对其影响。 方法： 本研究为横断面研究。选取2020年1月1日至2021年1月1日于北京医院体检中心进行体检的健康成年人。2位研究者分别使用Echopac专用右心室分析软件测量右心室各长轴应变指标［包括整体长轴应变（GLS）、心尖部长轴应变（ALS）、中段长轴应变（MLS）、基底段长轴应变（BLS）、游离壁整体长轴应变（FWGLS）、游离壁心尖部长轴应变（FWALS）、游离壁中段长轴应变（FWMLS）、游离壁基底段长轴应变（FWBLS）］及三尖瓣环收缩期位移（TAPSE），右心室面积变化（RVFAC），取平均值。采用组内相关系数（ICC）评价2位医师测量结果的一致性。 结果： 最终纳入233名受试者，年龄（58.5±14.2）岁，其中男性137例。所有测量指标的ICC值均≥0.8，一致性极好。健康成年人的右心室FWGLS和GLS平均值分别为-26.63%、-21.89%。男性及女性的TAPSE［（2.06±0.41）cm比（2.10±0.39）cm，P=0.510］和RVFAC［（51.17±9.91）%比（50.89±8.65）%，P=0.826］差异均无统计学意义。18~40和41~<65岁女性的各右心室长轴应变指标（GLS、ALS、MLS、BLS、FWGLS、FWALS、FWMLS、FWBLS）绝对值均高于同年龄段男性（P均<0.05），而在≥65岁受试者中两性的各右心室长轴应变指标绝对值差异均无统计学意义（P均>0.05）。女性中，18~40及41~<65岁受试者的右心室GLS、ALS、MLS、FWGLS、FWALS、FWMLS、FWBLS绝对值高于≥65岁受试者（P均<0.05）；而男性受试者中各年龄段间各右心室长轴应变指标差异均无统计学意义（P均>0.05）。 结论： 运用超声心动图二维斑点追踪技术测量右心室应变指标可行，并且重复性高；性别和年龄对右心室应变指标具有影响。.