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. 2016 Jun 23:12:38-44.
doi: 10.1016/j.ijcha.2016.05.007. eCollection 2016 Sep.

Accuracy of quantitative echocardiographic measures of right ventricular function as compared to cardiovascular magnetic resonance

Christian R Hamilton-Craig  1   2   3 , Kathy Stedman  1   4 , Ryan Maxwell  1 , Bonita Anderson  1   4 , Tony Stanton  2 , Jonathan Chan  1   5 , Akira Yamada  6   5 , Gregory M Scalia  1   2 , Darryl J Burstow  1   4   2
Affiliations

Accuracy of quantitative echocardiographic measures of right ventricular function as compared to cardiovascular magnetic resonance

Christian R Hamilton-Craig et al. Int J Cardiol Heart Vasc. .

Abstract

Background: Many echocardiographic parameters have been proposed to evaluate right ventricular (RV) systolic function. We comprehensively assessed a wide range of quantitative echocardiographic parameters in a single cohort compared with same-day cardiovascular magnetic resonance (CMR).

Methods and results: 92 subjects were examined prospectively: Group 1 consisted of 46 healthy controls (21 males, 33.4 ± 11.4 years), Group 2 consisted of 46 patients (20 males, 38.5 ± 18.9 years) undergoing RV functional assessment by CMR (1.5 T). Echocardiography was performed on the same day as CMR; fractional area change (RVFAC), myocardial performance index via spectral Doppler (RVMPI), RVMPI via Doppler tissue imaging (RVMPI-DTI), peak systolic myocardial velocity by DTI (RVSm), tricuspid annular plane systolic excursion (TAPSE), speckle tracking strain, and three dimensional right ventricular ejection fraction (3DE-RV). Linear regression, Bland-Altman and receiver-operator-characteristic (ROC) analyses were performed. At ROC analysis, the most predictive echocardiographic methods were; RVFAC (AUC = 0.892), RVMPI (AUC 0.785), TAPSE (AUC 0.849) and 3DE-RV (AUC 0.909). 3DE-RV appeared the most accurate compared to CMR, although underestimated true RV volumes.

Conclusion: As compared to CMR; 3DE-RV, RVFAC, TAPSE and RVMPI were the most reliable predictors of RV function. These parameters can be recommended for clinical use.

Keywords: 3DE, three dimensional echocardiography; 3DE-RV, three-dimensional echo right ventricular ejection fraction; CMR, cardiovascular magnetic resonance; DTI, Doppler tissue imaging; EF, ejection fraction; Echocardiography; IVCT, isovolumic contraction time; IVRT, isovolumic relaxation time; LV, left ventricle; MPI, myocardial performance index; Magnetic resonance imaging; RV, right ventricular; RVOT, right ventricular outflow tract; RVSm, peak systolic myocardial velocity; RVSm, s prime: right ventricular peak systolic myocardial velocity; Right ventricle; Right ventricular function; SR, strain rate; TAPSE, tricuspid annular peak systolic excursion; TOF, tetralogy of Fallot; TR, tricuspid regurgitation; ε, strain.

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Figures

Fig. 1
Fig. 1
Receiver-operator characteristic (ROC) curves demonstrating validity of (A) RVFAC, (B) RVMPI, (C) RVMPI-DTI, (D)TAPSE, (E) 3DE as compared to CMR RVEF.
Fig. 2
Fig. 2
Linear regression analysis demonstrating the linear relationship between MRI standard (CMR RVEF) and 3DE-RV.
Fig. 3
Fig. 3
Bland–Altman analysis between CMREF and 3DE-RV, demonstrating very good agreement.
Fig. 4
Fig. 4
Bland–Altman analysis of inter-observer reproducibility of 3D-RVEF.
Fig. 5
Fig. 5
Combined Groups: Bland Altman analysis between indexed CMR Diastolic volume and indexed 3DE-RV Diastolic volume/BSA.
See this image and copyright information in PMC

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