Three-dimensional echocardiographic assessment of right ventricular volume and function in patients with pulmonary hypertension

1997 ◽  
Vol 7 (3) ◽  
pp. 317-324 ◽  
Author(s):  
Howard D. Apfel ◽  
Zhanqing Shen ◽  
Lawrence M. Boxt ◽  
Robyn J. Barst ◽  
Aasha S. Gopal ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Three Dimensional ◽  
Ventricular Volume ◽  
Right Ventricular Volume ◽  
Resonance Imaging ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography ◽  
The Right

AbsractThe structural complexity of the right ventricle has made quantitative evaluation difficult. Conventional cross-sectional echocardiographic methods are limited by geometric assumptions and the position of the planes used for imaging. Previous reports have demonstrated accurate three-dimensional echocardiographic quantitation of the right ventricle in-vitro and in experimental animals. We adapted a previously described method for three-dimensional reconstruction of the left ventricle to compute right ventricular volume and ejection fraction in a clinical setting.We examined 29 patients aged from 2 to 42 years with pulmonary hypertension, by three-dimensional echocardiography and resonance imaging. Correlation and agreement were calculated for volumes and ejection fractions. Three-dimensional echocardiographic reconstruction, when compared to resonance imaging, yielded r values of 0.95 and 0.93, and mean differences (bias) of 31% ± 19% and 33% ± 18%, for systolic and diastolic volumes respectively. Interobserver variability was low (12.9% and 8.0%). Ejection fraction as calculated by three-dimensional echocardiography showed close agreement with resonance images (bias=l% ±7%). Three dimensional echocardiography is now a method of measuring right ventricular ejection fraction in the clinical setting which produces results comparable to those of resonance imaging. Volume measurements correlated well for systole and diastole, but consistently underestimated values produced from resonance images.

scholarly journals Three-dimensional echocardiography. In vivo validation for right ventricular volume and function.

Circulation ◽  
1994 ◽  
Vol 89 (5) ◽  
pp. 2342-2350 ◽  
Author(s):  
L Jiang ◽  
S C Siu ◽  
M D Handschumacher ◽  
J Luis Guererro ◽  
J A Vazquez de Prada ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Three Dimensional ◽  
Ventricular Volume ◽  
Right Ventricular Volume ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography ◽  
And Function ◽  
In Vivo Validation

Abstract 15413: Comparison of Right Ventricular Functional Indices Using Two-dimensional and Three-dimensional Echocardiography to Predict Outcomes in Pediatric Pulmonary Hypertension

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Pei-Ni Jone ◽  
SuHong Tong ◽  
D. Dunbar Ivy
Keyword(s):  
Pulmonary Hypertension ◽  
Adverse Events ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Three Dimensional ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography ◽  
Serial Evaluation ◽  
Rv Function

Background: Right ventricular (RV) function is an important determinant of outcomes in pulmonary hypertension (PH) patients. Conventional indices of fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), and RV tissue Doppler imaging myocardial performance index (RV TDI MPI) have been used as surrogates of RV function. RV ejection fraction (EF) from real time three-dimensional echocardiography (RT-3DE) has emerged as a quantitative evaluation of global RV function and has correlated well with cardiac magnetic resonance imaging. In this study, 3D RV EF was compared with conventional indices in the serial evaluation of RV function in pediatric PH patients to predict adverse events. Methods: Forty-eight pediatric PH patients (median age = 10 years (4 months - 27 years)) were evaluated serially (138 visits with median interval visit = 116 days (4 -368 days)) with RT-3DE to follow their ejection fraction (EF) and conventional indices from April, 2014 to May, 2015. Echocardiographic variables include measures of RV function: 3D RV EF, FAC, TAPSE, and RV TDI MPI. Adverse events included: initiation or intensification of intravenous vasodilator therapy, atrial septostomy, Pott’s shunt, or death. Receiver Operating Characteristics (ROC) analyses were performed to identify the best cut-offs in predicting adverse events in serial follow up of pediatric PH patients. Results: Patients were classified based on their World Health Classification (I = 16, II=16, III=11, IV=3). Two patients were not classified as they were too young. There were 13 adverse events. 3D RV EF was a good predictor of adverse events with highest area under curve (AUC) = 0.79, p<0.001(cut-off value of 38% = sensitivity 69%; specificity of 78%) compared to FAC has an AUC = 0.77, p<0.05 (cut-off value of 33% = sensitivity 63%; specificity of 78%). TAPSE and TV TDI MPI were not statistically significant (AUC = 0.54, p = 0.65; AUC 0.63, p = 0.09 respectively). Conclusion: 3D RV EF is a good index in predicting adverse events and was better than FAC, TAPSE, and RV TDI MPI in predicting adverse events in serial follow up of pediatric PH patients. 3D RV EF can be used as a noninvasive tool in the serial evaluation of RV function in pediatric PH patients as it is easily obtained clinically.

Sign in / Sign up

Export Citation Format

Share Document