Introduction: Myocardial work (MW) - the area of the myocardial stress-strain loop - can serve as a better metric of myocardial performance than volumetric or strain measures, as MW is independent of loading conditions and has been shown to reflect regional oxygen perfusion and glucose metabolism. In practice, MW has been estimated as the ventricular pressure-myocardial strain area (PSA) using echocardiography. However, the RV’s complex geometry and echo’s limited acoustic windows can limit this approach. Therefore, we seek to establish an alternative CT-based approach to map MW in the RV with high spatial resolution. We demonstrate our approach in three populations: repaired tetralogy of Fallot (rTOF) a right-heart-dominant disease, heart failure (HF) prior to LVAD implantation, a biventricular disease, and chronic thromboembolic pulmonary hypertension (CTEPH), a pulmonary vascular disease.
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