Quantitative assessment of regional right ventricular function with color kinesis

We used color kinesis, a recent echocardiographic technique that provides r egional information on the magnitude and timing of endocardial wall motion, to quantitatively assess regional right ventricular (RV) systolic and dias tolic properties in 76 subjects who were divided into five groups, as follo ws: normal (n = 20), heart failure (n = 15), pressure/volume overload (n = 14), pressure overload (n = 12), and RV hypertrophy (n = 15). Quantitative segmental analysis of color kinesis images was used to obtain regional frac tional area change (RFAC), which was displayed in the form of stacked histo grams to determine patterns of endocardial wall motion. Time curves of inte grated RFAC were used to objectively identify asynchrony of diastolic endoc ardial motion. When compared with normal subjects, patients with pressure o verload or heart failure exhibited significantly decreased endocardial moti on along the RV free wall. In the presence of mixed pressure/volume overloa d, the markedly increased ventricular septal motion compensated for decreas ed RV free wall motion. Diastolic endocardial wall motion was delayed in 17 of 72 segments (24%) in patients with RV pressure overload, and in 31 of 9 0 segments (34%) in patients with RV hypertrophy. Asynchrony of diastolic e ndocardial wall motion was greater in the latter group than in normal subje cts (16% versus 10%: p < 0.01). Segmental analysis of color kinesis images allows quantitative assessment of regional RV systolic and diastolic proper ties.