Feasibility of a New Image Processing (4D Auto LVQ) to Assessing Right Ventricular Function in Patients with Chronic Obstructive Pulmonary Disease

Abstract

A new single-beat three-dimensional (3D) real time echocardiographic semi-automatic images processing (4D Auto LVQ) allows accurate assessment of left ventricular function, but whether it is suitable for the evaluation of right ventricular function remains unknown. To evaluate the feasibility of this procedure for assessing right ventricular volumes and function, right ventricular end-diastolic volumes (RVEDV), end-systolic volumes (RVESV) and ejection fraction (RVEF), stroke volumes (SV) and cardiac output (CO) were computed in 49 patients with chronic obstructive pulmonary disease (COPD) using 4D Auto LVQ. The myocardial performance index (MPI) was obtained by Doppler tissue imaging. The RV function parameters were compared with MPI by linear correlation analysis. A comparison of the performance of these RV function parameters in discrimination between MPI at a value of >0.45 or not was done. Compared with normal subjects, patients with COPD had significantly greater RVEDV, RVESV, MPI and significantly lower RVEF. Significant correlations were found between RVEF and MPI (r = –0.67, p < 0.001). The areas under the receiver operating characteristic curve for RVEF in discrimination between MPI at a value of >0.45 or not were 0.72, while they were 0.55 for SV and 0.57 for CO, respectively. The overall sensitivity, specificity and accuracy for RVEF analysis in predicting a >0.45 MPI in patients with COPD was 78.57%, 66.67% and 73.46%, respectively. These data suggest that 4D Auto LVQ is a feasible method for right ventricular volumes and function quantification in patients with COPD. Further studies are needed to improve the accuracy of the measurements.