Comparison of echocardiographic methods with magnetic resonance imaging for assessment of right ventricular function in children

Helbing, Willem A.; Bosch, Hans G.; Maliepaard, Chris; Rebergen, Sidney A.; Geest, Rob J. van der; Hansen, Bettina E.; Ottenkamp, Jaap; Reiber, J. H. C.; Roos, Albert de

doi:10.1016/s0002-9149(99)80161-1

Cited by 246 publications

(155 citation statements)

References 27 publications

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“…[1][2][3] Because of its complex geometric shape and other spatial considerations, it has been notoriously difficult to noninvasively assess RV function. 4 Although RV ejection fraction can now be derived from volumetric data obtained by MRI or 3-dimensional echocardiography, the load dependency of ejection fraction limits its utility. 4,5 Indeed, validity of any single beat-derived ejection phase index of RV contractile function is questionable because changes in loading conditions, especially afterload, markedly influence such measurements.…”

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confidence: 99%

“…4 Although RV ejection fraction can now be derived from volumetric data obtained by MRI or 3-dimensional echocardiography, the load dependency of ejection fraction limits its utility. 4,5 Indeed, validity of any single beat-derived ejection phase index of RV contractile function is questionable because changes in loading conditions, especially afterload, markedly influence such measurements. Furthermore, the RV in congenital heart disease is frequently characterized by pressure or volume overload, obviating useful comparison of these ejection phase indexes with data derived in the normal RV.…”

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confidence: 99%

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Validation of Myocardial Acceleration During Isovolumic Contraction as a Novel Noninvasive Index of Right Ventricular Contractility

et al. 2002

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Background-We have demonstrated that myocardial acceleration during isovolumic contraction (IVA) is a sensitive index of left ventricular contractile function. In this study, we assessed the utility of IVA to measure right ventricular (RV) contractile function. Methods and Results-We examined 8 pigs by using tissue Doppler imaging of the RV free wall and simultaneous measurements of intraventricular pressure, volume, maximal elastance (e max ), preload recruitable stroke work, and dP/dt max by conductance catheterization. Animals were paced in the right atrium at a rate of 130 beats per minute (bpm).IVA was compared with elastance during contractility modulation by esmolol and dobutamine and during preload reduction and afterload increase by transient balloon occlusion of the inferior vena cava and pulmonary artery, respectively. Data were also obtained during incremental atrial pacing from 110 to 210 bpm. Esmolol led to a decrease in IVA and dP/dt max . During dobutamine infusion, IVA, dP/dt max , preload recruitable stroke work, and e max all increased significantly. During preload reduction and afterload increase, IVA remained constant up to a reduction of RV volume by 54% and an RV systolic pressure increase of 58%. Pacing up to a rate of 190 bpm led to a stepwise increase in IVA and dP/dt max , with a subsequent fall at a pacing rate of 210 bpm. Conclusions-IVA is a measurement of RV contractile function that is unaffected by preload and afterload changes in a physiological range and is able to measure the force-frequency relation. This novel index may be ideally suited to the assessment of acute changes of RV function in clinical studies.

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confidence: 99%

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confidence: 99%

Validation of Myocardial Acceleration During Isovolumic Contraction as a Novel Noninvasive Index of Right Ventricular Contractility

et al. 2002

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“…THERE IS INCREASING DEMAND for an accurate method to evaluate right ventricular volumes and function, both in ischemic heart disease and in the follow-up of patients with congenital heart disease (CHD) (1)(2)(3)(4)(5). Established imaging modalities, such as echocardiography and tomographic-gated blood pool scintigraphy, are limited by the complex shape of the right ventricle (3,6).…”

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confidence: 99%

“…Established imaging modalities, such as echocardiography and tomographic-gated blood pool scintigraphy, are limited by the complex shape of the right ventricle (3,6). This is in addition to the limitations due to acoustic access and the need for exposure to radiation, respectively.…”

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confidence: 99%

Comparison of right ventricular volume measurement between segmented k‐space gradient‐echo and steady‐state free precession magnetic resonance imaging

Alfakih

Thiele

Plein

et al. 2002

Magnetic Resonance Imaging

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Purpose:To compare right ventricular volume measurements and their reproducibility between steady-state free precession (SSFP) and conventional turbo gradient-echo (TGE) imaging. Materials and Methods:Right ventricular volumes and observer variabilities were compared between SSFP and TGE in 31 subjects (21 normal volunteers and 10 subjects with heart failure). For further internal validation of the right ventricular volumes, the left ventricle (LV) and right ventricle (RV) stroke volumes were compared for the normal volunteers. Results:The volumes as measured by SSFP were significantly larger than for TGE (mean bias end-diastolic volume [EDV] 11.1 Ϯ 14.2, end-systolic volume [ESV] 9.8 Ϯ 9.75). SSFP had lower interobserver variability (SSFP EDV -10.1 Ϯ 11.6 vs. TGE EDV -6.2 Ϯ 18.5) and intra-observer variability (SSFP EDV -2.0 Ϯ 6.3 vs. TGE EDV -6.1 Ϯ 14.8). The mean absolute differences between LV and RV stroke volumes for 21 normal volunteers were: TGE 5.8 Ϯ 12.9 (r 2 ϭ 0.72), SSFP 4.6 Ϯ 6.9 (r 2 ϭ 0.92).Conclusion: SSFP and TGE yield different measurement values of RV volumes with SSFP, providing a more reproducible measurement.

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“…In the SVR trial (Frommelt et al 2012), the volumes were obtained from the right ventricular area measured on the transverse apical 4-chamber view at the level of the tricuspid annulus ( Figure 6) as well as the right ventricular cavity length measured on the subcostal sagittal view ( Figure 7). Then right ventricular volumes were calculated using the biplane pyramidal method (Helbing et al 1995) and ejection fraction is obtained using the In the SVR cohort, the average right ventricle ejection fraction (RVEF) (46 % +/-9 %) and area fraction change (35 % +/-9%) were calculated to be low and that throughout the 14 months follow-up (Frommelt et al 2012). The incidence of moderate right ventricular dysfunction, assessed visually, has been recently shown to peak at three to six months post-Norwood procedure with an incidence of 11 % +/-3 % (Wilder, McCrindle, et al 2015b).…”

Section: Right Ventricular Ejection Fractionmentioning

confidence: 99%

Risk Factors for Death or Heart Transplant for Patients with Right Ventricular Dysfunction After the Norwood Procedure: A Secondary Analysis of the Single Ventricle Reconstruction Trial

Jean‐St‐Michel

Meza

Coles

et al. 2017

The Journal of Heart and Lung Transplantation

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We investigated patient and procedural factors associated with failure of staged palliation after the Norwood procedure in patients with right ventricular dysfunction (RVDfx).Patients from the Pediatric Heart Network Single Ventricle Reconstruction (SVR) Trial dataset were selected if RVDfx was present, defined as an ejection fraction of less than 44% and a fractional area of change of less than 35% on the post-Norwood echocardiogram. Transplantfree survival after the Norwood procedure was analyzed using multiphase parametric hazard analysis and factors associated with death or transplant were identified.In the SVR cohort, 123 (34%) infants had RVDfx. The six-month transplant-free survival was 87% (70%CI 82-91%). The independent factors associated with increased risk of death or transplant were BT shunt, increased RV size, infectious disease complications and low surgeon volume.Patient factors can help identify which patient with RVDfx is at higher risk of death and help decision making around early transplant listing.iii

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Comparison of echocardiographic methods with magnetic resonance imaging for assessment of right ventricular function in children

Cited by 246 publications

References 27 publications

Validation of Myocardial Acceleration During Isovolumic Contraction as a Novel Noninvasive Index of Right Ventricular Contractility

Validation of Myocardial Acceleration During Isovolumic Contraction as a Novel Noninvasive Index of Right Ventricular Contractility

Comparison of right ventricular volume measurement between segmented k‐space gradient‐echo and steady‐state free precession magnetic resonance imaging

Risk Factors for Death or Heart Transplant for Patients with Right Ventricular Dysfunction After the Norwood Procedure: A Secondary Analysis of the Single Ventricle Reconstruction Trial

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