Assessment of right ventricular volume and systolic function after percutaneous pulmonary valve implantation by real-time three-dimensional echocardiography

Abstract

Objective To investigate the alternation of right ventricular volume and systolic function in patients with severe pulmonary regurgitation under percutaneous pulmonary valve implantation(PPVI) by real-time three-dimensional echocardiography(RT-3DE). Methods Ten patients with severe pulmonary regurgitation were enrolled. The 2D echocardiography images and real-time 3D full volume images on apical four-chamber view on a Philips IE33 system were acquired before PPVI and at 3 days, 1 month, 3months and 6 months after PPVI.Right ventricular end diastolic volume(EDV), end systolic volume(ESV), stroke volume (SV), ejection fraction(EF), fractional area change(FAC), tricuspid annular plane systolic excursion(TAPSE), right ventricular longitudinal strain-free wall(RVLSf) and right ventricular longitudinal strain-septum(RVLSs) were analysed using off-line TomTec software, the differences among the five groups were compared, and correlation analysis was made between the CMR and RT-3DE measurements. Results The level of pulmonary regurgitation had decreased or disappeared after PPVI. Compared with the preoperation, EDV, ESV at 3 days, 1 month, 3months and 6 months after operation had decreased significantly. EF, FAC, TAPSE, RVLS had increased significantly(all P<0.05). There were close correlation in EDV, ESV, EF between RT-3DE and CMR(pre-operation r=0.811, 0.817, 0.807, post-operation r=0.735, 0.834, 0.800, all P<0.05). Conclusions RV volume notably decreases while RV systolic function remarkably improves. The RT-3DE is a helpful technology in the evaluation of right ventricular volume and systolic function in patients after PPVI. Key words: Echocardiography, real-time three-dimensional; Pulmonary valve insufficiency; Ventricular function, right