Semi-quantitative assessment of right ventricular function in comparison to a 3D volumetric approach: A cardiovascular magnetic resonance study

Abstract

Semi-quantitative assessment of right ventricular function in comparison to a 3D volumetric approach: A cardiovascular magnetic resonance study Abstract Right ventricular (RV) volume measurements with cardiovascular magnetic resonance (CMR) is considered the gold standard, but acquisition and analysis remain timeconsuming. The aim of our study was therefore to investigate the accuracy and performance of a semi-quantitative assessment of RV function in CMR, compared to the standard quantitative approach. Seventy-five subjects with pulmonary hypertension (15), anterior myocardial infarction (15), inferior myocardial infarction (15), Brugada syndrome (15) and normal subjects (15) underwent cine CMR. RV end-systolic and enddiastolic volumes were determined to calculate RV ejection fraction (EF). Four-chamber cine images were used to measure tricuspid annular plane systolic excursion (TAPSE). RV fractional shortening (RVFS) was calculated by dividing TAPSE by the RV end-diastolic length. RV EF correlated significantly with TAPSE (r = 0.62, p < 0.01) and RVFS (r = 0.67, p < 0.01). Sensitivity to predict RV dysfunction was comparable between TAPSE and RVFS, with higher specificity for RVFS, but comparable areas under the ROC curve. Intra-and inter-observer variability of RV EF was better than TAPSE (3%/4% versus 7%/15%, respectively). For routine screening in clinical practice, TAPSE and RVFS seem reliable and easy methods to identify patients with RV dysfunction. The 3D volumetric approach is preferred to assess RV function for research purposes or to evaluate treatment response.

Right ventricular function following surgical aortic valve replacement and transcatheter aortic valve implantation: A cardiovascular MR study

“…TAPSE measurement disregards RV dimensions and is less sensitive to subtle RV changes (14). This is an important limitation to relying on TAPSE alone to assess treatment response.…”

“…However, TAPSE assessment maybe insensitive to global RV performance and is confounded by paradoxical interventricular septal motion, and particularly following SAVR, thoracic wall pericardial adhesions. Furthermore, TAPSE is an insensitive marker of RVEF unless it falls below 35% (14). Even 3D echo can systematically underestimate RV volumes (15), such that CMR is considered the reference investigation for RV morphological and functional assessment.…”

Diagnostic accuracy and variability of three semi-quantitative methods for assessing right ventricular systolic function from cardiac MRI in patients with acquired heart disease

“…TAPSE and RVFAC were initially described in echocardiography with conflicting results according to various studies [18][19][20][21][22]. More recently, TAPSE and RVFS were also evaluated with cardiac MRI in a few studies [23,24] but to date, no cardiac MRI study has evaluated the interest of RVFAC compared with TAPSE and RVFS. Moreover, the reproducibility of these SQt methods and particularly the effect of observers' experience were not clearly reported.…”

Sleep disordered breathing and enlargement of the right heart after myocardial infarction

“…Left atrial systolic area (LA-SA) was significantly larger in patients from the SDB group compared with the no-SDB group both at baseline (18 …”

“…Both insertion points were then transferred to a single four-chamber view in order to calculate the distance of these two points in respect to each other in centimetres. TAPSE can be interpreted as a semi-quantitative evaluation of RVEF overall [18]. RV infarct size was assessed manually using planimetry on short-axis slices, delineating hyper-enhanced areas.…”