Quantitative assessment of tricuspid regurgitation using right and left ventricular stroke volumes obtained from tomographic equilibrium radionuclide ventriculography

Abstract Background Quantitative assessment of valve regurgitation using volumetric method by comparing right and left ventricular stroke volumes is still under investigations. Aims To investigate the accuracy of tomographic equilibrium radionuclide ventriculography (t-ERV) for the quantification of tricuspid regurgitation (TR). Methods and results Sixty-one patients (44 men; mean age 59±12 years) who underwent both t-ERV and transthoracic echocardiography (TTE) studies within 2 weeks for right ventricular systolic function assessment were eligible for inclusion. A sub-group of 22 patients underwent both t-ERV and CMR. Patients with mitral/aortic regurgitation by TTE were excluded of the study. TR regurgitant volume (RVol) was calculated using the proximal isovelocity surface area (PISA) method from TTE and the volumetric method (right ventricular stroke volume minus left ventricular stroke volume) from t-ERV. RVol tended to be higher using the ERV volumetric method as compared to PISA method (43±35 and 35±33 ml, respectively; P<0.0001). There was a significant correlation between RVol as assess by ERV and by TTE (R=0.95, P<0.0001). Intraclass correlation coefficient between TTE and ERV for TR quantification was 0.95 (P<0.0001). Among patients who underwent CMR, the correlation between RVol obtained by TTE and by t-ERV and CMR were R=0.81 and R=0.75, respectively (all P<0.0001), without difference between the two correlations (P=0.263). Linear regression (left) and Bland-Altma Conclusion TR assessment using the t-ERV correlates well with PISA from TTE in patients referred for right ventricular systolic function assessment.

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Effects of Rest and Exercise on Cardiac Blood Volume Determinations

Nuklearmedizin ◽

10.1055/s-0038-1629844 ◽

1997 ◽

Vol 36 (08) ◽

pp. 259-264

Author(s):

N. Topuzović

Keyword(s):

Radionuclide Ventriculography ◽

Left Ventricular ◽

Peak Exercise ◽

Volume Determination ◽

Group I ◽

Lv Volumes ◽

Group Ii ◽

Lv Volume

Summary Aim: The purpose of this study was to investigate the changes in blood activity during rest, exercise and recovery, and to assess its influence on left ventricular (LV) volume determination using the count-based method requiring blood sampling. Methods: Forty-four patients underwent rest-stress radionuclide ventriculography; Tc-99m-human serum albumin was used in 13 patients (Group I), red blood cells was labeled using Tc-99m in 17 patients (Group II) in vivo, and in 14 patients (Group III) by modified in vivo/in vitro method. LV volumes were determined by a count-based method using corrected count rate in blood samples obtained during rest, peak exercise and after recovery. Results: In group I at stress, the blood activity decreased by 12.6 ± 5.4%, p <0.05, as compared to the rest level, and increased by 25.1 ± 6.4%, p <0.001, and 12.8 ± 4.5%, p <0.05, above the resting level in group II and III, respectively. This had profound effects on LV volume determinations if only one rest blood aliquot was used: during exercise, the LV volumes significantly decreased by 22.1 ± 9.6%, p <0.05, in group I, whereas in groups II and III it was significantly overestimated by 32.1 ± 10.3%, p <0.001, and 10.7 ± 6.4%, p <0.05, respectively. The changes in blood activity between stress and recovery were not significantly different for any of the groups. Conclusion: The use of only a single blood sample as volume aliquot at rest in rest-stress studies leads to erroneous estimation of cardiac volumes due to significant changes in blood radioactivity during exercise and recovery.

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New Hybrid Method for Left Ventricular Ejection Fraction Assessment from Radionuclide Ventriculography Images

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616666201118122509 ◽

2020 ◽

Vol 16 ◽

Author(s):

Halima Dziri ◽

Mohamed Ali Cherni ◽

Dorra Ben Sellem

Keyword(s):

Left Ventricular Ejection Fraction ◽

Left Ventricle ◽

Ejection Fraction ◽

Positive Predictive Value ◽

Roc Curve ◽

Radionuclide Ventriculography ◽

Left Ventricular ◽

The Other ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction

Background: In this paper, we propose a new efficient method of radionuclide ventriculography image segmentation to estimate the left ventricular ejection fraction. This parameter is an important prognostic factor for diagnosing abnormal cardiac function. Methods: The proposed method combines the Chan-Vese and the mathematical morphology algorithms. It was applied to diastolic and systolic images obtained from the Nuclear Medicine Department of Salah AZAIEZ Institute.In order to validate our proposed method, we compare the obtained results to those of two methods of the literature. The first one is based on mathematical morphology, while the second one uses the basic Chan-Vese algorithm. To evaluate the quality of segmentation, we compute accuracy, positive predictive value and area under the ROC curve. We also compare the left ventricle ejection fraction estimated by our method to that of the reference given by the software of the gamma-camera and validated by the expert, using Pearson’s correlation coefficient, ANOVA test and linear regression. Results and conclusion: Static results show that the proposed method is very efficient in the detection of the left ventricle. The accuracy was 98.60%, higher than that of the other two methods (95.52% and 98.50%). Likewise, the positive predictive value was the highest (86.40% vs. 83.63% 71.82%). The area under the ROC curve was also the most important (0.998% vs. 0.926% 0.919%). On the other hand, Pearson's correlation coefficient was the highest (99% vs. 98% 37%). The correlation was significantly positive (p<0.001).

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Quantitative Assessment of Alterations in Regional Left Ventricular Contractility With Color-Coded Tissue Doppler Echocardiography

Circulation ◽

10.1161/01.cir.95.10.2423 ◽

1997 ◽

Vol 95 (10) ◽

pp. 2423-2433 ◽

Cited By ~ 206

Author(s):

John Gorcsan ◽

David P. Strum ◽

William A. Mandarino ◽

Vijay K. Gulati ◽

Michael R. Pinsky

Keyword(s):

Doppler Echocardiography ◽

Quantitative Assessment ◽

Tissue Doppler ◽

Left Ventricular ◽

Tissue Doppler Echocardiography ◽

Ventricular Contractility ◽

Left Ventricular Contractility

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Prognostic Value of Echocardiographic Right Ventricular Function Parameters in the Presence of Severe Tricuspid Regurgitation

Journal of Clinical Medicine ◽

10.3390/jcm10112266 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2266

Author(s):

Matthias Schneider ◽

Varius Dannenberg ◽

Andreas König ◽

Welf Geller ◽

Thomas Binder ◽

...

Keyword(s):

Right Ventricular ◽

Ventricular Function ◽

Tricuspid Regurgitation ◽

Right Ventricular Function ◽

Prognostic Value ◽

Large Scale ◽

Systolic Function ◽

Left Ventricular ◽

Severe Tricuspid Regurgitation ◽

Vena Contracta

Background: Presence of severe tricuspid regurgitation (TR) has a significant impact on assessment of right ventricular function (RVF) in transthoracic echocardiography (TTE). High trans-valvular pendulous volume leads to backward-unloading of the right ventricle. Consequently, established cut-offs for normal systolic performance may overestimate true systolic RVF. Methods: A retrospective analysis was performed entailing all patients who underwent TTE at our institution between 1 January 2013 and 31 December 2016. Only patients with normal left ventricular systolic function and with no other valvular lesion were included. All recorded loops were re-read by one experienced examiner. Patients without severe TR (defined as vena contracta width ≥7 mm) were excluded. All-cause 2-year mortality was chosen as the end-point. The prognostic value of several RVF parameters was tested. Results: The final cohort consisted of 220 patients, 88/220 (40%) were male. Median age was 69 years (IQR 52–79), all-cause two-year mortality was 29%, median TAPSE was 19 mm (15–22) and median FAC was 42% (30–52). In multivariate analysis, TAPSE with the cutoff 17 mm and FAC with the cutoff 35% revealed non-significant hazard ratios (HR) of 0.75 (95%CI 0.396–1.421, p = 0.38) and 0.845 (95%CI 0.383–1.867, p = 0.68), respectively. TAPSE with the cutoff 19 mm and visual eyeballing significantly predicted survival with HRs of 0.512 (95%CI 0.296–0.886, p = 0.017) and 1.631 (95%CI 1.101–2.416, p = 0.015), respectively. Conclusions: This large-scale all-comer study confirms that RVF is one of the main drivers of mortality in patients with severe isolated TR. However, the current cut-offs for established echocardiographic parameters did not predict survival. Further studies should investigate the prognostic value of higher thresholds for RVF parameters in these patients.

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