Quantitative Assessment of Right Ventricular Volumes and Ejection Fraction in Patients with Left Ventricular Systolic Dysfunction by Real Time Three-Dimensional Echocardiography versus Cardiac Magnetic Resonance Imaging.

The aim of this study was to assess the accuracy and reproducibility of real time three-dimensional echocardiographic (RT3DE) for the determination of right ventricular (RV) volumes and function in patients with left ventricular (LV) systolic dysfunction. Dedicated RT3DE was prospectively performed to assess RV volumes and EF in patients with LV systolic function identified on routine clinical cardiac magnetic resonance (CMR) imaging. RV end-diastolic volume (RV EDV), RV end-systolic volume (RV ESV), and RV EF were obtained using an offline analysis software (TomTec) by two observers blinded to CMR results. In this population of 27 patients with LV systolic dysfunction with a mean LV EF of 36 ± 12%, RV RT3DE dataset could be assessed in 27 of 30 patients (90%). High correlation was noted between RT3DE and CMR for RV EDV, ESV, and EF (r = 0.90, 0.89, and 0.77, respectively). RV EDV was lower by RT3DE as compared to CMR (129 ± 52 vs. 142 ± 53 mL, P = 0.005) while there was no significant difference in RV ESV and RV EF (71 ± 37 vs. 77 ± 45 mL, P = 0.146; 45 ± 11 vs. 48 ± 13%, P = 0.134, respectively). The intraclass correlation coefficient ranged from 0.94 to 0.94 between measurements and from 0.84 to 0.96 between observers. Overall, RV volumes and EF assessed by RT3DE correlate well with CMR measurements in patients with LV dysfunction. RT3DE may be used as a more widely available and versatile alternative to CMR for the quantitative assessment of RV size and function in patients with LV dysfunction.

Kim J ，Cohen SB ，Atalay MK ，Maslow AD ，Poppas A ... -  《-》

Right ventricular global longitudinal strain is an independent predictor of right ventricular function: a multimodality study of cardiac magnetic resonance imaging, real time three-dimensional echocardiography and speckle tracking echocardiography.

Accurate assessment of right ventricular (RV) systolic function is important, as it is an established predictor of mortality in cardiac and respiratory diseases. We aimed to compare speckle tracking-derived longitudinal deformation measurements with traditional two-dimensional (2D) echocardiographic parameters, as well as real time three-dimensional echocardiography (RT3DE) and cardiac magnetic resonance imaging (CMR)-derived RV volumes and ejection fraction (EF). Subjects referred for CMR also underwent echocardiography. On both RT3DE and CMR, we measured RV volumes and EF. On 2D echocardiography, we analyzed RV fractional area change, RV internal diastolic diameter, tricuspid annular plane systolic excursion, tricuspid annular tissue Doppler-derived velocity, myocardial performance index, and RV global longitudinal strain (RV GLS). Sixty subjects were recruited (mean age = 45 ± 10 years; 60% male). RV GLS (R = -0.69, P < 0.001) and RT3DE RVEF (R = 0.56, P < 0.001) correlated well with CMR RVEF. RT3DE RV end-diastolic (RVEDV) and end-systolic (RVESV) volumes also correlated with CMR RV volumes: RVEDV, R = 0.74, P < 0.001 and RVESV, R = 0.84, P < 0.001. In addition, RV GLS best predicted the presence of RV dysfunction, defined as RVEF <48% on CMR (hazard ratio = 7.0 [1.5-31.7], P < 0.01). On receiver operator characteristic analysis, a RV GLS of -20% was the most sensitive and specific predictor of RV dysfunction (AUC 0.8 [0.57-1.0], P < 0.02). RVEF and volumes estimated on RT3DE were closely correlated with CMR measurements. When compared to more traditional markers of RV systolic function and RT3DE, RVGLS produced the highest correlation with CMR RVEF and was a good predictor of RV dysfunction. RV GLS should be considered a complementary modality to RT3DE and CMR in the assessment of RV systolic function.

Lu KJ ，Chen JX ，Profitis K ，Kearney LG ，DeSilva D ，Smith G ，Ord M ，Harberts S ，Calafiore P ，Jones E ，Srivastava PM ... -  《-》

Knowledge-based reconstruction of right ventricular volumes using real-time three-dimensional echocardiographic as well as cardiac magnetic resonance images: comparison with a cardiac magnetic resonance standard.

Right ventricular volume quantification using real-time three-dimensional echocardiographic (RT3DE) imaging is limited by technical shortcomings of acquisition and quantification. In this study, a two-step approach was used to overcome these limitations. First, a modified acquisition technique for RT3DE imaging was applied, and second, a software tool using knowledge-based reconstruction (KBR) was used. The approach was validated against the gold standard, cardiac magnetic resonance (CMR) imaging, using CMR and RT3DE data sets from healthy children and from patients with congenital heart disease. Sixty individuals (20 healthy persons, 40 with congenital heart defects; age range, 2.3-43.9 years; median age, 11.3 years) consecutively underwent investigation by CMR and RT3DE imaging. CMR data sets were first quantified by the method of disks (MOD) as the standard. Then CMR and RT3DE data sets were quantified using KBR software and compared with the MOD. CMR was more feasible than echocardiography (100% vs 88%). Compared with the MOD (CMRMOD), there were trivial volume overestimations of KBR for CMR data (CMRKBR), of end-diastolic volume (EDV) (-1.3 ± 8.6%, r = 0.984) and end-systolic volume (ESV) (-3.4 ± 13.3%, r = 0.985), resulting in a 0.7 ± 8.7% difference in ejection fraction (EF) (r = 0.882). Comparing CMRMOD and RT3DE imaging, EDV (1.1 ± 7.4%, r = 0.990) and EF (0.8 ± 9.2%, r = 0.871) were slightly underestimated by RT3DE imaging, with a slight overestimation of ESV (-1.5 ± 13.3%, r = 0.977). Intraobserver variability was excellent for KBR of CMR and RT3DE data, with interclass coefficients of correlation of 0.995 and 0.997 for EDV, 0.995 and 0.994 for ESV, and 0.915 and 0.912 for EF. Interobserver variability provided intraclass correlation coefficients of 0.992 and 0.990 for EDV, 0.997 and 0.992 for ESV, and 0.953 and 0.933 for EF. The KBR analysis required a mean time of 5 min. KBR is an accurate, versatile, and time-saving method for right ventricular three-dimensional volumetry; it shows excellent reproducibility for RT3DE and CMR data sets. These results suggest that this tool is clinically valuable.

Laser KT ，Horst JP ，Barth P ，Kelter-Klöpping A ，Haas NA ，Burchert W ，Kececioglu D ，Körperich H ... -  《-》

Evaluation of left and right ventricular ejection fraction and volumes from gated blood-pool SPECT in patients with dilated cardiomyopathy: comparison with cardiac MRI.

Xie BQ ，Tian YQ ，Zhang J ，Zhao SH ，Yang MF ，Guo F ，Wang DY ，Wei HX ，Chu KW ，He ZX ... -  《-》

Rapid online quantification of left ventricular volume from real-time three-dimensional echocardiographic data.

Jacobs LD ，Salgo IS ，Goonewardena S ，Weinert L ，Coon P ，Bardo D ，Gerard O ，Allain P ，Zamorano JL ，de Isla LP ，Mor-Avi V ，Lang RM ... -  《EUROPEAN HEART JOURNAL》