Abstract

BackgroundThe convenience and availability of real-time three-dimensional echocardiography (RT3DE) makes it an attractive candidate for assessing right ventricle function. However, the viability of RT3DE is not conclusive.Aim of StudyThis study aims to evaluate RT3DE relative to cardiac magnetic resonance and 2-dimensional echocardiography (2DE) for measuring right ventricular systolic function in patients with pulmonary hypertension.MethodsPatients with pulmonary hypertension (n = 23) underwent cardiac magnetic resonance, 2DE, and RT3DE. Specifically, 2DE was used to measure the right ventricular index of myocardial performance (RIMP), fractional area change, tricuspid annular plane systolic excursion (TAPSE), and tissue Doppler-derived tricuspid annular systolic velocity (S′). Cardiac magnetic resonance and RT3DE were used to measure right ventricular end-diastolic volume (RVEDV) and end-systolic volume (RVESV). The right ventricular ejection fraction (RVEF) was calculated.ResultsRegarding the measurements taken by 2DE, RVEF positively correlated with fractional area change (r = 0.595, P = 0.003) and S′(r = 0.489, P = 0.018), and negatively correlated with RIMP (r = −0.745, P = 0.000). There was no association between RVEF and TAPSE (r = −0.029, P = 0.896). There existed a close correlation between the values of RVEDV, RVESV, and RVEF as measured by RT3DE and CMR respectively (P<0.001); Bland-Altmanan analyses showed good agreement between them.ConclusionRT3DE was a viable method for noninvasive, accurate assessment of right ventricular systolic function in patients with pulmonary hypertension.

Highlights

  • Most patients with pulmonary hypertension have marked right ventricle (RV) dysfunction

  • Regarding the measurements taken by 2-dimensional echocardiography (2DE), RV ejection fraction (RVEF) positively correlated with fractional area change (r = 0.595, P = 0.003) and S0(r = 0.489, P = 0.018), and negatively correlated with right ventricular index of myocardial performance (RIMP) (r = −0.745, P = 0.000)

  • There was no association between RVEF and tricuspid annular plane systolic excursion (TAPSE) (r = −0.029, P = 0.896)

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Summary

Introduction

Most patients with pulmonary hypertension have marked right ventricle (RV) dysfunction. Accurate assessment of RV structure and function is crucial to the management of patients with pulmonary hypertension. Two-dimensional (2D) echocardiography (2DE) is the most commonly used clinical imaging method for functional evaluation of the right ventricle. M-Mode and tissue Doppler imaging of the free lateral wall of the RV are measured in one plane clinically, and are used as surrogates for RV function. Real-time three-dimensional (3D) echocardiography (RT3DE) is able to display the 3D anatomy of the RV; simultaneously depicting both longitudinal and transverse movements [2].This feature makes it superior to conventional two-dimensional methods in RV function assessment. The convenience and availability of real-time three-dimensional echocardiography (RT3DE) makes it an attractive candidate for assessing right ventricle function.

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