Right ventricular strain in Anderson-Fabry disease

Rosa Lillo, Francesca Graziani, Elena Panaioli, Erica Mencarelli, Maurizio Pieroni, Antonia Camporeale, Raffaele Manna, Ludovico Luca Sicignano, Elena Verrecchia, Antonella Lombardo, Gaetano Antonio Lanza, Filippo Crea

Research output: Contribution to journalArticlepeer-review


BACKGROUND: 2D speckle tracking echocardiography (2DSTE) is superior to standard echocardiography in the assessment of subtle right ventricle (RV) systolic dysfunction. In this study we aimed to: 1) test the hypothesis that 2DSTE may unveil subtle RV systolic dysfunction in patients with Fabry disease; 2) investigate whether the physiologic difference between the 3-segment (RV-FWS) and the 6-segment (RV-GLS) RV strain (∆RV strain) is preserved in Fabry patients.

METHODS AND RESULTS: Standard echocardiography and 2DSTE were performed in 49 Fabry patients and 49 age- and sex-matched healthy controls. Fabry patients were divided in two groups according to the presence/absence of left ventricular hypertrophy (LVH+: left ventricular wall thickness > 12 mm, 49% of total Fabry patients). RV systolic function assessed by standard echocardiography was normal in the majority of Fabry patients (92%) while RV-GLS and RV-FWS were impaired in about 40%. RV-GLS and RV-FWS were significantly worse in patients LVH+ vs LVH- and vs controls (RV-GLS: LVH+ vs LVH-: -18.4 ± -4.3% vs -23.8 ± -3.1% p<0.001; LVH+ vs controls: -18.4 ± -4.3% vs -23.9 ± -2.8% p<0.001; RV-FWS: LVH+ vs LVH-: -21.8 ± -5.3% vs -26.7 ± -3.8% p = 0.002, LVH+ vs controls -21.8 ± -5.3% vs -26.8 ± -3.9% p<0.001). No difference was found between LVH- patients and controls in both RV-GLS (p = 0.65) and RV-FWS (p = 0.79). ∆RV strain was similar among the groups.

CONCLUSIONS: In Fabry cardiomyopathy impaired RV-GLS and RV-FWS is a common finding, while RV strain is preserved in Fabry patients without overt cardiac involvement. The physiologic difference between RV-FWS and RV-GLS is maintained in Fabry patients, regardless of the presence of cardiomyopathy.

Original languageEnglish
Pages (from-to)84-90
Number of pages7
JournalInt. J. Cardiol.
Publication statusPublished - May 1 2021


  • Echocardiography
  • Fabry Disease/diagnostic imaging
  • Heart Ventricles/diagnostic imaging
  • Humans
  • Ventricular Dysfunction, Right/diagnostic imaging
  • Ventricular Function, Right


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