The increased longitudinal basal-to-apical strain ratio in the right ventricular free wall is associated with neonatal pulmonary hypertension

It has been a challenging work to identify and assess neonatal pulmonary hypertension (PH). Right ventricular longitudinal strain (RVLS) is primarily used in evaluating right ventricular (RV) systolic function. This study aimed to investigate the association of the changes in segmental and global RVLS with neonatal PH, hoping to provide a new marker for indicating neonatal PH other than obtaining information on RV function. This was a cross-sectional study with 62 neonates, generally divided into PH and non-PH groups confirmed by echocardiography. For 30 infants later diagnosed with bronchopulmonary dysplasia (BPD), specific analysis was conducted by subdividing them into BPD with and without PH subgroups. Conventional echocardiography markers and the global and segmental RVLS were measured and compared. Their diagnostic performance in evaluating PH was analyzed. Regardless of grouping, the biventricular function of all infants was similar and in normal range. No significant difference was found in global strain parameters, either. In the case of PH, tricuspid regurgitant velocity (TRV), left ventricle systolic eccentricity index (LVsEI), and the basal-to-apical strain ratio (Ratio bas/api ) of RV free wall (RVFW) were significantly higher ( P