Evaluation of Right Atrial Size in Patients with Atrial Arrhythmias: Comparison of 2D versus Real Time 3D Echocardiography

Müller, Hajo; Burri, Haran; Lerch, René

doi:10.1111/j.1540-8175.2008.00674.x

Cited by 29 publications

(40 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our retrospective review of clinically acquired studies prohibited direct volume measurements as the short-axis images of the heart were truncated just basal to the atrioventricular valves and therefore did not cover the entire right atrium. However, the correlation between the area-length measurement and the volumetric measurement of RA volume is relatively good both by echocardiography (r = 0.70 for area-length method vs. 3D echo method [37]) and MRI (r = 0.65 vs. real RA volume [35]). While we assessed RAEF by cMRI , which is not available for patient care in all areas, this parameter can also be estimated by echocardiography as well such that further analyses of echo-derived RAEF in PH will be of interest.…”

Section: Discussionmentioning

confidence: 98%

Right atrial emptying fraction non-invasively predicts mortality in pulmonary hypertension

Darsaklis

Dickson

Cornwell

et al. 2016

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

Right-sided heart failure is the most common cause of death in pulmonary hypertension (PH). Echocardiographic measurements of right atrial (RA) size are associated with worse outcome in PH, however the association between RA function and death in PH has not been well-described. 160 PH patients (World Health Organization groups 1-5) underwent cardiac magnetic resonance imaging (cMRI) and right heart catheterization (RHC) within 6 weeks of each other at a tertiary care academic medical center in the United States. We measured cMRI RA maximum and minimum volumes indexed to body surface area and calculated RA emptying fraction (RAEF). We evaluated the relationship between RAEF and clinical variables with death using Cox proportional hazard models. 57 deaths occurred during a median follow-up of 3.5 years (36 % died overall, 10 % per year). RAEF was directly correlated in univariate analyses with right ventricular (RV) ejection fraction, left ventricular (LV) ejection fraction, LV size, cardiac index, absence of tricuspid and pulmonic regurgitation, absence of pericardial effusion, estimated glomerular filtration rate, 6-minute walk distance, and pulmonary arterial oxygen saturation, whereas it was inversely correlated with death, BNP, heart rate, mean RA pressure, mean PA pressure, pulmonary and systemic vascular resistance, RV size, and RA size. Using multivariate analyses, RAEF had a robust inverse association with death after adjusting for measured risk factors (HR per 5 % change in RAEF: 0.83 [95 % CI 0.73-0.94], p = 0.003). In PH patients, decreased RAEF by cMRI is independently associated with worse survival after adjustment for other risk factors.

show abstract

Section: Discussionmentioning

confidence: 98%

Right atrial emptying fraction non-invasively predicts mortality in pulmonary hypertension

Darsaklis

Dickson

Cornwell

et al. 2016

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

show abstract

“…This has been explained by the relative insensitivity of conventional and TDI-derived echocardiographic methods that may not be able to detect early abnormalities in longitudinal function, in contrast to strain rate imaging methods. [18][19][20][21][22][23] However, the implied superiority of strain imaging emerged almost exclusively from examinations of the left ventricle [18][19][20]24) which may not be simply transferred to the right ventricle. Moreover, although regional RV strain represents a potential means to assess myocardial contractility that is less load-dependent, there is still a lack of normative data and the measure is angle dependent with a poor-signal-to noise ratio.…”

Section: Discussionmentioning

confidence: 99%

Relation Between Obesity, Metabolic Syndrome, Successful Long-Term Weight Reduction, and Right Ventricular Function

et al. 2016

View full text Add to dashboard Cite

SummaryThis study sought to examine the relationships between right ventricular (RV) function and geometry, morbid obesity with and without the metabolic syndrome, and the effect of long-term weight loss. Obese (n = 153, BMI 41.2 ± 8.7 kg/m 2 ) and healthy non-obese control subjects (n = 38, BMI 25.5 ± 3.3 kg/m 2 ) of similar age and gender distribution were prospectively studied during the course of a 1-year weight reduction program with echocardiography at baseline and after one year of follow up. Function and geometry of the right heart were evaluated by tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (TDI S'), RV myocardial performance index (TEI), RV end-diastolic (RVEDD) and end-systolic diameter (RVESD), area of the right atrium (RAA), and systolic pulmonary artery pressure (PAP). Whereas parameters of systolic and diastolic LV function were significantly worse in the obese subjects than those in the non-obese subjects (EF 66 ± 6 versus 69 ± 6%, P = 0.004; E/E' 7.4 ± 2.5 versus 6.3 ± 2.6, P = 0.010), parameters of RV function (TAPSE 25.6 ± 4.5 versus 25.1 ± 3.5 mm, P = 0.528; TDI S' 13.5 ± 2.9 versus 13.8 ± 2.9 mm/second, P = 0.553; TEI 0.25 ± 0.13 versus 0.28 ± 0.09, P = 0.283) as well as geometry measurements were comparable between the obese and non-obese participants and also in obese subjects with full blown metabolic syndrome. Additionally, successful weight reduction did not alter the RV parameters. Nevertheless, in the few obese subjects with RV dysfunction (n = 7), metabolic syndrome parameters were more pronounced than in obese with normal RV function.Morbid obesity with and without the metabolic syndrome is accompanied by an impaired LV systolic and diastolic function. In contrast, RV function appears to be less affected by obesity independent of the presence of the metabolic syndrome. (Int Heart J 2016; 57: 441-448) Key words: Adiposity, Heart failure, Echocardiography O besity and the metabolic syndrome are fast-growing disorders in western countries which are associated with variant cardiovascular abnormalities leading to a high risk of cardiovascular morbidity and mortality.1) The Framingham Heart Study demonstrated a 2-fold higher risk of developing heart failure in obese subjects with a body mass index ≥ 30 kg/m 2 in comparison to non-obese ones in a large community-based sample.2) Moreover, adiposity was described as an independent risk factor for developing heart failure with a population attributable risk of 8.0% in a large prospective cohort study with a follow-up of 19 years. 3)Adiposity results in different subclinical changes in cardiac function.1) Arterial hypertension, impaired glucose tolerance, dyslipidemia, altered hemodynamics, elevation of neurohumoral and inflammatory markers, prothrombotic state, and obstructive sleep apnea are associated conditions which may further predispose to heart failure. [2][3][4] While the influence of obesity on left ventricular (LV) function is understood in more detail, such as the correlation of body ...

show abstract

“…58 The feasibility of RT3DE evaluation of right atrial (RA) volume and its superiority over 2DE measurements also were recently demonstrated. 59 Nevertheless, RT3DE measurements of either LA or RA volumes have yet to be validated against an independent reference technique such as CMR. Importantly, these studies require CMR acquisition to be specifically targeted to LA or RA quantification, including appropriate imaging planes and sufficient number of slices, to provide accurate CMR reference values.…”

Section: Rt3de Evaluation Of Atrial Volumesmentioning

confidence: 99%

Real-Time 3-Dimensional Echocardiography

2009

View full text Add to dashboard Cite

O ne of the most significant developments of the last decade in ultrasound imaging of the heart was the evolution of 3-dimensional (3D) imaging from slow and labor-intense offline reconstruction to real-time volumetric imaging. This imaging modality provides valuable clinical information that empowers echocardiographers with new levels of confidence in the diagnosis of heart disease. We have previously described the technological milestones in the development of real-time 3D echocardiographic (RT3DE) imaging and its major advantages over conventional 2-dimensional echocardiography (2DE) and reviewed the published literature that supported the use of this new methodology in clinical practice. 1 Since 2006, the growing availability of RT3DE technology, its ease of use, and its multiple attractive features have sparked significant interest in the research community, resulting in a large number of publications, most of which have endorsed RT3DE imaging for clinical use by demonstrating its unique capabilities in different scenarios. In parallel, the clinical acceptance of this new tool has broadened significantly. The most recent clinically significant addition is matrix-array transesophageal echocardiography (TEE), which provides images of unprecedented quality that aid surgeons and interventional cardiologists in planning and guiding procedures and evaluating their outcomes.The purpose of the present article is to review the most recent RT3DE literature and provide readers with an update on the latest developments and the current status of this noninvasive imaging tool. Because different potential applications of RT3DE imaging have been explored to various extents, they are described here separately, and each is discussed with an emphasis on the scientifically established facts, along with the known stumbling blocks and difficulties. Quantification of LV Volumes and FunctionA firmly established advantage of 3D imaging over crosssectional slices of the heart is the improvement in the accuracy of the evaluation of left ventricular (LV) volumes and ejection fraction (EF) by eliminating the need for geometric modeling, which is inaccurate in the presence of aneurysms, asymmetrical ventricles, or wall motion abnormalities, and the errors caused by foreshortened views even in symmetrical ventricles. The value of RT3DE imaging in this context has been demonstrated by multiple studies that compared RT3DE volume measurements with widely accepted reference techniques, including radionuclide ventriculography and cardiac magnetic resonance (CMR). [2][3][4][5][6] These studies and others have demonstrated higher levels of agreement between the RT3DE approach and the respective reference technique compared with conventional 2DE methodology. Additionally, RT3DE measurements were found to be more reproducible than 2DE 4,5,7 and, in some studies, even as reproducible as CMR. 8 Interestingly, in a recent study in patients after myocardial infarction (MI), 9 RT3DE-derived LV volumes were more accurate and more reproducible than thos...

show abstract

Evaluation of Right Atrial Size in Patients with Atrial Arrhythmias: Comparison of 2D versus Real Time 3D Echocardiography

Cited by 29 publications

References 21 publications

Right atrial emptying fraction non-invasively predicts mortality in pulmonary hypertension

Right atrial emptying fraction non-invasively predicts mortality in pulmonary hypertension

Relation Between Obesity, Metabolic Syndrome, Successful Long-Term Weight Reduction, and Right Ventricular Function

Real-Time 3-Dimensional Echocardiography

Contact Info

Product

Resources

About