Abstract

AimAssessment of right ventricular (RV) function is a challenge, especially in patients with congenital heart disease (CHD). The aim of the present study is to assess whether knowledge-based RV reconstruction, used in the everyday practice of an echo-lab for adult CHD in a tertiary referral center, is accurate when compared to cardiac magnetic resonance (CMR) examination.Subjects and methodsAdult patients who would undergo CMR for assessment of the RV were asked to undergo an echo of the heart for further knowledge-based reconstruction (KBR). Echocardiographic images were acquired in standard views using a predefined imaging protocol. RV volumes and ejection fraction (EF) calculated using knowledge-based technology were compared with the CMR data of the same patient.ResultsNineteen consecutive patients with congenital right heart disease were studied. Median age of the patients was 28 years (range 46 years). Reconstruction was possible in 16 out of 19 patients (85%). RV volumes assessed with this new method were smaller than with CMR. Indexed end diastolic volumes were 114±17 ml vs 121±19 ml, P<0.05 and EFs were 45±8% vs 47±9%, P<0.05 respectively. The correlation between the methods was good with an intraclass correlation of 0.84 for EDV and 0.89 for EF, P value <0.001 in both cases.ConclusionKBR enables reliable measurement of RVs in patients with CHDs and can be used in clinical practice for analysis of volumes and EFs.

Highlights

  • Assessment of right ventricular (RV) function is a challenge due to its complex and alternated morphology, especially in patients with congenital heart disease (CHD)

  • RV volumes assessed with knowledge-based reconstruction (KBR) were smaller than cardiac magnetic resonance (CMR)

  • KBR end diastolic volume indexed (EDVi) 114G17 ml vs CMR EDVi 121G19 ml (P!0.05), end systolic volume indexed (ESVi) 63G14 ml vs 64G16 ml (P value 0.5) and RVEF 45G8% vs 47G9% respectively (P!0.05). The agreement between both methods assessed with intraclass correlation (ICC) was of 0.84 for RV EDVi, 0.90 for RV ESVi and 0.89 for RVEF, P value !0.001

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Summary

Introduction

Assessment of right ventricular (RV) function is a challenge due to its complex and alternated morphology, especially in patients with congenital heart disease (CHD). KBR has shown to be accurate compared to CMR in children with various congenital heart anomalies (8) and in adults with the RV in systemic position and in pulmonary arterial hypertension (9, 10)

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