Novel Approach to Three-Dimensional Echocardiographic Quantification of Right Ventricular Volumes and Function from Focused Views

Medvedofsky, Diego; Addetia, Karima; Patel, Amit R.; Sedlmeier, Anke; Baumann, Rolf; Mor‐Avi, Victor; Lang, Roberto M.

doi:10.1016/j.echo.2015.06.013

Cited by 107 publications

(95 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With a combination of image optimization during suspended expiration or inspiration as well as judicious use of nonstandard RV views and specific attention to patient position, it is possible to obtain reasonable-quality RV data sets, especially in subjects with normal-sized right ventricles. Additionally, endocardial tracings of the right ventricle using 3D data sets have become easier in the past few years 13,14 with the availability of new and more user-friendly software that allows tracings to be performed in short- and long-axis planes. Given this new method for RV assessment, the difficulty associated with RV analysis lies mainly with adequacy of the 3D acquisition.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Morphologic Analysis of the Normal Right Ventricle Using Three-Dimensional Echocardiography–Derived Curvature Indices

Addetia

Maffessanti

Muraru

et al. 2018

Journal of the American Society of Echocardiography

Self Cite

View full text Add to dashboard Cite

Background Right ventricular (RV) remodeling involves changes in size, wall thickness, function, and shape. Previous studies have suggested that regional curvature indices (rCI) may be useful for RV shape analysis. The aim of this study was to establish normal three-dimensional echocardiographic values of rCI in a large group of healthy subjects to facilitate future three-dimensional echocardiographic study of adverse RV remodeling. Methods RV endocardial surfaces were reconstructed at end-diastole and end-systole in 245 healthy subjects (mean age, 42 ± 12 years) and analyzed using custom software to calculate mean curvature in six regions: RV inflow tract (RVIT) and RV outflow tract, apex, and body (both divided into free wall and septal regions). Associations with age and gender were studied. Results The apical free wall was convex, while the septum (apex and body) was more concave than the body free wall. Septal curvature did not change significantly from end-diastole to end-systole. The RV outflow tract and RVIT became flatter from end-diastole to end-systole. In keeping with the “bellows-like” action of RV contraction, the body free wall became flatter, while the apex free wall changed to a more convex surface. There were no intergender differences in rCI. In older subjects (≥55 years of age), the RV free wall and RV outflow tract were flatter, and from end-diastole to end-systole, the RVIT became less flattened and the apex less pointed. These changes suggest that the right ventricle is stiffer in older subjects, with less dynamic contraction of the RVIT and less bellows-like movement. Conclusions This study established normal three-dimensional echocardiographic values for RV rCI, which are needed to further study RV diastolic dysfunction and remodeling with disease.

show abstract

Section: Discussionmentioning

confidence: 99%

“…RV contours were manually initialized in end-systolic and end-diastolic frames in the short- and long-axis planes, while including the trabeculae in the RV cavity. 13,14 Side-by-side display of dynamic tracking of endocardial borders throughout the cardiac cycle enabled end-diastolic and end-systolic contour adjustments.…”

Section: Methodsmentioning

confidence: 99%

Morphologic Analysis of the Normal Right Ventricle Using Three-Dimensional Echocardiography–Derived Curvature Indices

Addetia

Maffessanti

Muraru

et al. 2018

Journal of the American Society of Echocardiography

Self Cite

View full text Add to dashboard Cite

show abstract

“…Three-dimensional transthoracic echocardiography (3DTTE) has the advantage of full-volume acquisition of the entire right ventricle, which may overcome the technical and clinical limitations of 2-dimensional transthoracic echocardiography. [10][11][12] Recent studies have validated the accuracy of 3DTTE-determined RV volumes and RVEF against CMR 13,14 and determined the reference values of RV volumes and RVEF in healthy subjects. 15,16 However, the prognostic value of RVEF is largely unknown.…”

mentioning

confidence: 99%

Prognostic Value of Right Ventricular Ejection Fraction Assessed by Transthoracic 3D Echocardiography

Nagata

Kado

et al. 2017

Circ: Cardiovascular Imaging

144

View full text Add to dashboard Cite

R ight ventricular (RV) function is closely coupled with subsequent morbidity and mortality in patients with diseases affecting the right heart chambers. [1][2][3][4][5][6][7] The most common cause of RV dysfunction is chronic left-sided heart failure. Complex factors such as pulmonary hypertension, intrinsic myocardial involvement, ventricular interdependence, and myocardial ischemia lead to RV dysfunction. 1 Therefore, assessment of RV function is clinically important in almost all patients with heart disease. However, the complex geometry of the RV poses a significant limitation to the reliable quantitation of RV volumes and ejection fraction (RVEF) using 2-dimensional transthoracic echocardiography. Although cardiac magnetic resonance (CMR) imaging is the gold standard for the evaluation of RV volumes and RVEF, 8,9 factors such as cost, portability, time consumption, and contraindications hinder its routine use in every patient. Three-dimensional transthoracic echocardiography (3DTTE) has the advantage of full-volume acquisition of the entire right ventricle, which may overcome the technical and clinical limitations of 2-dimensional transthoracic echocardiography. [10][11][12] Recent studies have validated the accuracy of 3DTTE-determined RV volumes and RVEF against CMR 13,14 and determined the reference values of RV volumes and RVEF in healthy subjects. 15,16 However, the prognostic value of RVEF is largely unknown. We hypothesized that RVEF assessed by 3DTTE (3DRVEF) would offer incremental value over left ventricular (LV) functional parameters for predicting future cardiac events. See Editorial by Fernández-Golfín and Zamorano See Clinical PerspectiveAccordingly, the aims of this study were (1) to validate the accuracy of 3DTTE-determined RV volumes and RVEF against CMR reference and (2) to evaluate the prognostic value of 3DRVEF to predict future cardiac death and major adverse cardiac events (MACEs) in a large number of patients.Background-Cardiac magnetic resonance is the gold standard for the evaluation of right ventricular (RV) volumes, but it is impractical to perform in every patient. Although reference values of RV volumes and RV ejection fraction by 3D transthoracic echocardiography (3DTTE) have been established, their prognostic values have not been elucidated yet. We hypothesized that RV ejection fraction measured by 3DTTE (3DRVEF) predicts future cardiovascular events. Methods and Results-In protocol 1, we determined the accuracy of RV volumes and RV ejection fraction measurements by 3DTTE against cardiac magnetic resonance in 60 subjects. In protocol 2, 3DRVEF was measured in 446 patients with various cardiovascular diseases. Study subjects were followed up to record cardiac death and major adverse cardiovascular events. In protocol 1, 3DTTE-determined RV end-diastolic volume, end-systolic volume, and RV ejection fraction had good correlations to those by cardiac magnetic resonance (r=0.74-0.90). In protocol 2, 38 cardiac deaths and 88 major adverse cardiovascular events occurred during a med...

show abstract

“…A new methodology for a volumetric analysis of the RV, eliminating the need for extraction of coronal views from a 3D data set, was recently implemented. It proved to be fast and highly reproducible on a large cohort of patients with different RV size and function, and its results correlate well with the CMR [25,26]. Other important limitations of the technique include, possible dropout of the RV anterior wall, incomplete visualisation in case of severe dilation, the need for regular heart rate, and patients' cooperation.…”

Section: Quantitative Assessmentmentioning

confidence: 81%

Use of novel echocardiographic techniques to assess right ventricular geometry and function

et al. 2016

View full text Add to dashboard Cite

Novel Approach to Three-Dimensional Echocardiographic Quantification of Right Ventricular Volumes and Function from Focused Views

Cited by 107 publications

References 35 publications

Morphologic Analysis of the Normal Right Ventricle Using Three-Dimensional Echocardiography–Derived Curvature Indices

Morphologic Analysis of the Normal Right Ventricle Using Three-Dimensional Echocardiography–Derived Curvature Indices

Prognostic Value of Right Ventricular Ejection Fraction Assessed by Transthoracic 3D Echocardiography

Use of novel echocardiographic techniques to assess right ventricular geometry and function

Contact Info

Product

Resources

About