IJCS | Volume 31, Nº6, November / December 2018

636 Figure 3 - Correlation between fractional area change (FAC) (a), peak systolic velocity (PSV) of tricuspid annulus by tissue Doppler (b), tricuspid annular plane systolic excursion (TAPSE) (c), right ventricular (RV) free wall longitudinal strain (RVFWS) (d), RV global longitudinal strain (RVGS) (e), and RV ejection fraction (RVEF), measured by three-dimensional echocardiography. Felix et al. RV function by 2D strain in left-sided valve disease Int J Cardiovasc Sci. 2018;31(6)630-642 Original Article to surgery indication in appropriate timing. In this regard, STE based techniques as 2DS have shown good applicability and reproducibility for the evaluation of RV function, with great accuracy in detecting RVdysfunction when compared to gold standard methods. A population of severe mitral and/or aortic valve disease patientswas enrolled in this study, predominantly rheumatic in etiology, unlike other studies from Europe and North America that also evaluated RV function in VHD patients, in which the predominant etiology was degenerative valvular disease. 22,23 In Brazil, rheumatic fever is still a prevalent cause of VHD, and almost 60% of the patients that undergo cardiac surgery for valvular repair or replacement have rheumatic etiology. 24 These