Dynamic Assessment of Right Ventricular Volumes and Function by Real-Time Three-Dimensional Echocardiography: A Comparison Study With Magnetic Resonance Imaging in 100 Adult Patients

Leibundgut, Gregor; Rohner, A; Grize, Leticia; Bernheim, Alain; Kessel-Schaefer, Arnheid; Bremerich, Jens; Zellweger, Michael J.; Buser, Peter; Handke, Michael

doi:10.1016/j.echo.2009.11.016

Cited by 190 publications

(131 citation statements)

References 30 publications

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“…119 RVEDV calculations of 3D data sets are available, with good correlations with other techniques, such as the MRI. 120,121 The lower reference limit for RVEF is 44%, from the disk summation method in adult patients. In a recent study by Kong et al, 122 regional and global RV systolic dysfunction in adult PH patients measured by 3D echocardiography were inversely related to the pulmonary arterial systolic pressure and PVR.…”

Section: D Echocardiographymentioning

confidence: 99%

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

et al. 2016

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Transthoracic echocardiography (TTE) is the most accessible noninvasive diagnostic procedure for the initial assessment of pediatric pulmonary hypertension (PH). This review focuses on principles and use of TTE to determine morphologic and functional parameters that are also useful for follow-up investigations in pediatric PH patients. A basic echocardiographic study of a patient with PH commonly includes the hemodynamic calculation of the systolic pulmonary artery pressure (PAP), the mean and diastolic PAP, the pulmonary artery acceleration time, and the presence of a pericardial effusion. A more detailed TTE investigation of the right ventricle (RV) includes assessment of its size and function. RV function can be evaluated by RV longitudinal systolic performance (e.g., tricuspid annular plane systolic excursion), the tricuspid regurgitation velocity/right ventricular outflow tract velocity time integral ratio, the fractional area change, tissue Doppler imaging-derived parameters, strain measurements, the systolic-to-diastolic duration ratio, the myocardial performance (Tei) index, the RV/left ventricle (LV) diameter ratio, the LV eccentricity index, determination of an enlarged right atrium and RV size, and RV volume determination by 3-dimensional echocardiography. Here, we discuss the potential use and limitations of TTE techniques in children with PH and/or ventricular dysfunction. We suggest a protocol for TTE assessment of PH and myocardial function that helps to identify PH patients and their response to pharmacotherapy. The outlined protocol focuses on the detailed assessment of the hypertensive RV; RV-LV crosstalk must be analyzed separately in the evaluation of different pathologies that account for pediatric PH.

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Section: D Echocardiographymentioning

confidence: 99%

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

et al. 2016

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“…Strain and strain-rate imaging provides an accurate, yet indirect, assessment of RV myocardial performance [2]. Three-dimensional echocardiography provides more accurate RV volume measurements than 2D echocardiography, yet compared with CMR it consistently underestimates RV volume [3][4][5]. This is probably due to incomplete depiction of the right ventricle.…”

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confidence: 82%

“…This is probably due to incomplete depiction of the right ventricle. Also, in 3D echocardiography image quality was insufficient in approximately one fourth of patients [3][4][5].CMR, on the other hand, is contraindicated in patients with a defibrillator or an MRI-unsafe pacemaker. Therefore, in the present issue, Winter and colleagues studied whether CT may be an alternative to CMR for the determination of RV volumes and function in TGA patients with a contraindication to CMR…”

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confidence: 99%

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Tailor-made right ventricular imaging

Meijs

2012

Neth Heart J

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Right ventricular (RV) performance has a major role in the clinical status and prognosis of patients with congenital heart disease, especially in patients with a systemic right ventricle such as patients with congenitally corrected transposition of the great arteries (TGA) or with TGA corrected by a Mustard or Senning operation.Quantification of RV function is challenging for several reasons. Especially in echocardiography, the anterior position of the right ventricle in the chest causes near-field artifacts, which may preclude visualisation of the RV apex. Also, the complex morphology of the right ventricle makes an estimation of volumes based on two-dimensional (2D) measurements unreliable. Thirdly, exact delineation of the thin and highly trabecularised RV wall is difficult.Several modalities are available to assess RV function, of which cardiac magnetic resonance imaging (CMR) and echocardiography are most frequently used in clinical practice. CMR is considered the standard of reference, yet CMR is more costly and less widely available than echocardiography. RV volume measurements by 2D echocardiography correlate poorly with CMR [1]. Strain and strain-rate imaging provides an accurate, yet indirect, assessment of RV myocardial performance [2]. Three-dimensional echocardiography provides more accurate RV volume measurements than 2D echocardiography, yet compared with CMR it consistently underestimates RV volume [3][4][5]. This is probably due to incomplete depiction of the right ventricle. Also, in 3D echocardiography image quality was insufficient in approximately one fourth of patients [3][4][5].CMR, on the other hand, is contraindicated in patients with a defibrillator or an MRI-unsafe pacemaker. Therefore, in the present issue, Winter and colleagues studied whether CT may be an alternative to CMR for the determination of RV volumes and function in TGA patients with a contraindication to CMR[6]. They studied 35 TGA patients; of these patients 20 underwent CMR to measure RV volumes and ejection fraction. In the remaining 15 patients, in whom CMR was contraindicated due to the presence of a pacemaker or defibrillator, RV volumes and ejection fraction were determined by CT. The authors found that the intra-and interobserver variability of RV volumes and ejection fraction measured with CT were higher compared with those with CMR. However, except for RV stroke volume these differences in variability were not statistically significant. Although the current study provides no direct intra-patient comparison between CMR and CT, previous studies demonstrated adequate correlation of RV volumes and function measured with 64-slice CT and those with CMR [7]. However, the more limited temporal resolution of 16-slice CT resulted in a systemic over-estimation of RV end-systolic volume [8].As also addressed by Winters et al., CT is associated with radiation and iodine contrast material. The radiation dose of 14 mSv in the current study is substantial, especially for relatively young patients who are likely to receive additi...

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“…7). 3DE measurements are closely correlated (but slightly underestimate) with RV volumes measured by CMR both in children and adults [18][19][20][21], and by volumetric thermodilution during cardiac catheterisation [22]. Normative data for 3DE RV volumes and ejection fraction (EF) including age-, body size-, and sex-specific reference values based on large cohort studies of healthy volunteers have recently become available (Table 2) [23,24].…”

Section: Quantitative Assessmentmentioning

confidence: 99%

Use of novel echocardiographic techniques to assess right ventricular geometry and function

et al. 2016

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Dynamic Assessment of Right Ventricular Volumes and Function by Real-Time Three-Dimensional Echocardiography: A Comparison Study With Magnetic Resonance Imaging in 100 Adult Patients

Cited by 190 publications

References 30 publications

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

Tailor-made right ventricular imaging

Use of novel echocardiographic techniques to assess right ventricular geometry and function

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