Comparison of echocardiographic parameters to assess right ventricular function in pulmonary hypertension

Abstract

Although measurement of right ventricular ejection fraction (RVEF) may be relevant for evaluation of therapeutic efficacy and/or prognosis in patients with pulmonary hypertension, RVEF obtained by echocardiography has limited accuracy. In contrast, radionuclide and/or magnetic resonance imaging can measure RVEF more reliably. In this study, we investigated the relationship between RVEF measured by radionuclide angiography and the echocardiographic parameters that are recommended by the American Society of Echocardiography as representative of right heart function. There were 23 study participants with pulmonary hypertension who underwent radionuclide angiography and 2-dimensional and Doppler echocardiography (n = 30 measurements). RVEF measured by radionuclide angiography correlated with right ventricular Tei index (RV Tei index) measured by Doppler echocardiography (r = -0.601, P < 0.0005). Receiver operating characteristic curve analysis showed that an RV Tei index cut-off value of 0.371 was the best of predictor of RVEF ≤35% (area under the curve = 0.768, sensitivity = 0.857, selectivity = 0.667). Multiple regression analysis showed that RVEF was correlated with the RV Tei index, and this association was independent of other echocardiographic right ventricular function parameters (r = -0.644, P < 0.005). The RV Tei index measured by Doppler echocardiography may be an acceptable surrogate marker of RVEF in patients with pulmonary hypertension.

Right Ventricular Function in Heart Failure Patients with Normal Left Ventricular Size: Analysis by Conventional Echocardiographic Parameters and Magnetic Resonance Imaging

“…Despite the load dependency of RVMPI, the high reproducibility makes it a proper index to estimate RV performance. Furthermore, the acceptable accuracy of RVMPI to assess RV performance was mentioned by other authors in different clinical situations (18)(19)(20). In parallel with other studies, Vizzardi et al (21) documented that pulsed Doppler RVMPI > 0.38 is a predictor of cardiovascular death and hospitalization in HF patients with LVEF < 40% and NYHA class II.…”

Usefulness of scoring right ventricular function for assessment of prognostic factors in patients with chronic thromboembolic pulmonary hypertension

“…In the present study, both RV-MPI and RVFAC favorably reflected the hemodynamics in patients with CTEPH. Previously, Amano et al reported that RV-MPI is a surrogate marker for the right ventricular ejection fraction (RVEF) assessed by MRI in patients with CTEPH [ 22 ]. RV-MPI is an index that combines RV systolic and diastolic function to evaluate RV function.…”

Evaluation of echocardiographic derived parameters for right ventricular size and function using cardiac magnetic resonance imaging

“…16 Other studies have challenged that many of these measurements were not well established prior to their recommendation by the ASE. 20 Finally, sonographers and echocardiographers are often unable to make many of the measurements in clinical practice due to difficult imaging. 21 These measurements have shown varying degrees of correlation with the gold standard of volumetric analysis by cMRI.…”