Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Oct;21(10):2111-20.
doi: 10.1007/s00330-011-2152-0. Epub 2011 May 26.

Diagnostic accuracy and variability of three semi-quantitative methods for assessing right ventricular systolic function from cardiac MRI in patients with acquired heart disease

Jérôme Caudron  1 , Jeannette Fares, Pierre-Hugues Vivier, Valentin Lefebvre, Caroline Petitjean, Jean-Nicolas Dacher
Affiliations

Diagnostic accuracy and variability of three semi-quantitative methods for assessing right ventricular systolic function from cardiac MRI in patients with acquired heart disease

Jérôme Caudron et al. Eur Radiol. 2011 Oct.

Abstract

Objectives: To evaluate the diagnostic accuracy and variability of 3 semi-quantitative (SQt) methods for assessing right ventricular (RV) systolic function from cardiac MRI in patients with acquired heart disease: tricuspid annular plane systolic excursion (TAPSE), RV fractional-shortening (RVFS) and RV fractional area change (RVFAC).

Methods: Sixty consecutive patients were enrolled. Reference RV ejection fraction (RVEF) was determined from short axis cine sequences. TAPSE, RVFS and RVFAC were measured on a 4-chamber cine sequence. All SQt analyses were performed twice by 3 observers with various degrees of training in cardiac MRI. Correlation with RVEF, intra- and inter-observer variability, and receiver operating characteristic (ROC) curve analysis were performed for each SQt method.

Results: Correlation between RVFAC and RVEF was good for all observers and did not depend on previous cardiac MRI experience (R range = 0.716-0.741). Conversely, RVFS (R range = 0.534-0.720) and TAPSE (R range = 0.482-0.646) correlated less with RVEF and depended on previous experience. Intra- and inter-observer variability was much lower for RVFAC than for RVFS and TAPSE. ROC analysis demonstrated that RVFAC <41% could predict a RVEF <45% with 90% sensitivity and 94% specificity.

Conclusions: RVFAC appears to be more accurate and reproducible than RVFS and TAPSE for SQt assessment of RV function by cardiac MRI.

PubMed Disclaimer

Conflict of interest statement

Competing interests

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Study design
AHD = acquired heart disease; ES = end-systole; ED = end-diastole; LV = left ventricle; RV = right ventricle.
Figure 2
Figure 2. Basal short axis slice selection for the right ventricle
A four-chamber view was used to locate the tricuspid annulus plane.
Figure 3
Figure 3. Bland Altman plots: intra-observer variability of RV functional parameters in relation to previous observer’s experience
x axis = average of the 2 measurements of the observer; y axis = differences between the 2 measurements of the observer; RV = right ventricle; EF = ejection fraction; EDV = end diastolic volume; ESV = end systolic volume.
Figure 4
Figure 4. Bland Altman plots: effect of processing steps on intra-observer variability for RV functional parameters
x axis = average of the 2 measurements of the observer; y axis = differences between the 2 measurements of the observer.
See this image and copyright information in PMC

References

    1. Ghio S, Gavazzi A, Campana C, Inserra C, Klersy C, Sebastiani R, Arbustini E, Recusani F, Tavazzi L. Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure. J Am Coll Cardiol. 2001;37:183–8. - PubMed
    1. Mehta SR, Eikelboom JW, Natarajan MK, Diaz R, Yi C, Gibbons RJ, Yusuf S. Impact of right ventricular involvement on mortality and morbidity in patients with inferior myocardial infarction. J Am Coll Cardiol. 2001;37:37–43. - PubMed
    1. Mendes LA, Dec GW, Picard MH, Palacios IF, Newell J, Davidoff R. Right ventricular dysfunction: an independent predictor of adverse outcome in patients with myocarditis. Am Heart J. 1994;128:301–7. - PubMed
    1. Juillière Y, Barbier G, Feldmann L, Grentzinger A, Danchin N, Cherrier F. Additional predictive value of both left and right ventricular ejection fractions on long-term survival in idiopathic dilated cardiomyopathy. Eur Heart J. 1997;18:276–80. - PubMed
    1. Haddad F, Hunt SA, Rosenthal DN, Murphy DJ. Right ventricular function in cardiovascular disease, Part I: Anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation. 2008;117:1436–48. - PubMed