Cardiac MRI right ventricle / left ventricle (RV/LV) volume ratio improves detection of RV enlargement

Altmayer, Stephan; Patel, Amit R.; Addetia, Karima; Gomberg‐Maitland, Mardi; Forfia, Paul R.; Han, Yuchi

doi:10.1002/jmri.25110

Cited by 19 publications

(17 citation statements)

References 22 publications

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“…The ratio of RVEDV to LVEDV is a parameter employed to evaluate the size and function of the RV. 25,26 The ratio of RVEDV to LVEDV among Chinese subjects has been shown to be lower than that of subjects of European descent, as reported by Altmayer et al 26 Our study is the first to detail the ratio of RVEDV to LVEDV for a Chinese population, which should be valuable reference for the future study of the RV in Chinese population. Differences between the sexes with regard to ventricular parameters has been reported in several studies.…”

Section: Discussionsupporting

confidence: 60%

Reference values of cardiac ventricular structure and function by steady‐state free‐procession MRI at 3.0T in healthy adult chinese volunteers

Lei

Liu

Han

et al. 2016

Magnetic Resonance Imaging

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Section: Discussionsupporting

confidence: 60%

Reference values of cardiac ventricular structure and function by steady‐state free‐procession MRI at 3.0T in healthy adult chinese volunteers

Lei

Liu

Han

et al. 2016

Magnetic Resonance Imaging

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“…27 In addition, the ratio of right ventricle volume to left ventricle volume has also been found to be a sensitive index of RV enlargement in PAH. 30 Thus, it is not surprising that RVEI is also a powerful indicator of PAH.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and prognostic value of right ventricular eccentricity index in pulmonary artery hypertension

et al. 2020

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The right ventricle experiences dynamic changes under pressure overload in pulmonary artery hypertension. This study aimed to evaluate the diagnostic and prognostic value of right ventricular eccentricity index (RVEI) in pulmonary artery hypertension. A total of 100 pulmonary artery hypertension patients (mean age, 36.85 (SD, 13.60) years; males, 30.0%) confirmed by right heart catheterization and 147 healthy volunteers (mean age 45.58 (SD, 17.58) years; males, 42.50%) were enrolled in this prospective study. All participants underwent cardiac magnetic resonance imaging (MRI) examination, and balanced steady-state free precession (bSSFP) cine sequences were acquired. RVEI was measured on short-axis cine images at the mid-ventricular level of the right ventricle in end systole. The study found that RVEI was significantly lower in pulmonary artery hypertension patients than in healthy volunteers (1.84 (SD, 0.40) vs. 2.46 (SD, 0.40); p < 0.001). In pulmonary artery hypertension patients, RVEI was correlated with log(NT-proBNP) (r = −0.388; p < 0.001), right ventricular end-diastolic volume index (r = −0.452; p < 0.001), right ventricular end-systolic volume index (r = −0.518; p < 0.001), and right ventricular ejection fraction (r = 0.552; p < 0.001). RVEI could discriminate pulmonary artery hypertension patients from healthy volunteers with 91.8% sensitivity and 68.0% specificity. Over median follow-up of 14.8 months (interquartile range: 6.7–26.9 months), RVEI was demonstrated to be an independent predictor for adverse outcome (HR = 0.076; 95% CI, 0.013-0.458; p = 0.005). In conclusion, MRI-derived RVEI appears to be a useful diagnostic and prognostic value in pulmonary artery hypertension, and it provides incremental value to risk stratification strategy.

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“…Ventricular segmentation was performed using QMASS (Medis, Leiden, The Netherlands) by one observer following the Society for Cardiovascular Magnetic Resonance guidelines 10 . Data from intra- and inter-observer reproducibility were previously published 5 .…”

Section: Methodsmentioning

confidence: 99%

“…Statistical analysis was performed using SPSS v.23 (IBM Corp, Armonk, NY). The cutoffs for RV enlargement for RVEDVi and RV/LV volume ratio were defined as values higher than two standard deviations (SD) from the mean in a control population: RVEDVi ≥104 ml/m 2 for females, ≥113 ml/m 2 for males, and RV/LV volume ratio ≥1.27 for both genders 5 . Shapiro-Wilk test was used to test for normality.…”

Section: Methodsmentioning

confidence: 99%

“…However, indexing to BSA is not perfect and RVEDVi does not account for the size of the adjacent left ventricle (LV) and may fail to detect dilation in patients with smaller hearts. In light of this limitation, we have shown that RV/LV volume ratio is a more sensitive parameter to detect RV dilation than RVEDVi 5 . In our previous work 5 , in a group 152 controls, we determined the normal range of the RV/LV volume ratio to be 0.906 to 1.266, and found that combining this parameter (RV/LV volume ratio ≥1.27) with RVEDVi yielded a higher detection of RV enlargement in a population with pulmonary arterial hypertension (PAH).…”

Section: Introductionmentioning

confidence: 99%

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Using all-cause mortality to define severe RV dilation with RV/LV volume ratio

Altmayer

Han

Addetia

et al. 2018

Sci Rep

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Right ventricular (RV) end-diastolic volume (EDV) to left ventricular (LV) EDV ratio using cardiovascular magnetic resonance imaging (CMR) is an important parameter for RV size evaluation in additional to indexed EDV. We explore the severity partition for RV dilation using mortality in a population of 62 patients with pulmonary hypertension (PH). Cine short-axis images were acquired with a 1.5 T MR scanner using a steady-state free precession sequence. The optimal cutoff to classify severe RV dilation was determined by a receiver-operating curve (ROC) analysis based on mortality. We further defined mild and moderate categories by the standard deviation distance between normal and severely dilated and found the categories RV dilation by RV/LV volume ratio to be “mild” (1.27–1.69), “moderate” (1.70–2.29) and “severe” (≥2.30). There were significant differences in RVEDV and RV ejection fraction between “mild”, “moderate” and “severe” groups (p < 0.001). The “severe” category had a significantly higher mortality when compared to the “non-severe” categories (p < 0.001) while there was no difference among the “non-severe” dilated groups. We have shown that severe RV dilation partition can be defined using mortality with RV/LV volume ratio, which offers an outcome based grading of the “severe” category of RV dilation.

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Cardiac MRI right ventricle / left ventricle (RV/LV) volume ratio improves detection of RV enlargement

Abstract: Combining RV/LV volume ratio with indexed RVEDV increased detection of RV enlargement in a PAH population. This result may have potential impact in RV size assessment. J. Magn. Reson. Imaging 2016;43:1379-1385.

Cited by 19 publications

References 22 publications

Reference values of cardiac ventricular structure and function by steady‐state free‐procession MRI at 3.0T in healthy adult chinese volunteers

Reference values of cardiac ventricular structure and function by steady‐state free‐procession MRI at 3.0T in healthy adult chinese volunteers

Diagnostic and prognostic value of right ventricular eccentricity index in pulmonary artery hypertension

Using all-cause mortality to define severe RV dilation with RV/LV volume ratio

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