1003-5 Feasibility of a Two Dimensional Echocardiographic Method for the Clinical Assessment of Right Ventricular Volume and Function

Abstract

Obtaining non-invasive measurements of right ventricular (RV) volume and function has been a long standing challenge. Radionuclide techniques (MUGA) for RV evaluation are limited by problems of border recognition and chamber overlap. Magnetic Resonance Imaging (MRI) measurements of ventricular volumes have been previously validated; however, this technique is limited by expense and time necessary for acquisition and analysis. A 2D echo technique has been previously described (Levine et al Circ 69: 497) that uses the simple product of length and area measurements of two orthogonal planes (apical 4 chamber and subxyphoid short). Apical (AP) and RV Outflow (OT) methods were used. Good correlation has been reported in vitro, however, no validation in a clinical setting has been reported to date. We obtained 20 echo measurements of RV volumes and election fraction (EF) by this method and compared our results to MRI data in patients over a wide range of volumes and function, 8 patients were studied, ages ranged from 5 to 42 years. Regression Bias (mean percent differences) Variability (intra- observer) 20 vs. MRI MRI range r SEE EDV (AP) 7 53–302 ml 0.99 13 l3 –24% 12% ESV (AP) 7 27–224 ml 0.99 9 ml –19% 13% EF (AP) 7 27–63% 0.99 4% –27% EDV (OT) 8 0.98 13 ml –24% 5% ESV (OT) 8 0.99 7 ml –30% 15% EF (OT) 8 0.96 4% –5% Preliminary data show an excellent correlation and small SEE of 2d echo volumes and EF compared to MRI. There is a significant 2D echo bias underestimating MRI. Assessment of EF by this 2D method may be clinically useful for serial follow up of RV function.