Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-28T01:05:54.706Z Has data issue: false hasContentIssue false
  • English
  • Français

Three-dimensional echocardiographic assessment of right ventricular volume and function in patients with pulmonary hypertension

Published online by Cambridge University Press:  19 August 2008

Howard D. Apfel ,
Zhanqing Shen ,
Lawrence M. Boxt ,
Robyn J. Barst ,
Aasha S. Gopal ,
Lindsey D. Allan ,
Welton M. Gersony  and
Donald L. King
Howard D. Apfel*
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Babies and Children's Hospital, Columbia University College of Physicians and Surgeons, New York, NY, USA
Zhanqing Shen
Affiliation:
Department of Medicine, Division of Cardiology, Columbia University College of Physicians and Surgeons, New York, NY, USA
Lawrence M. Boxt
Affiliation:
Department of Radiology, The Presbyterian Hospital in the City of New York, NY, USA
Robyn J. Barst
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Babies and Children's Hospital, Columbia University College of Physicians and Surgeons, New York, NY, USA
Aasha S. Gopal
Affiliation:
Department of Medicine, Division of Cardiology, Columbia University College of Physicians and Surgeons, New York, NY, USA
Lindsey D. Allan
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Babies and Children's Hospital, Columbia University College of Physicians and Surgeons, New York, NY, USA
Welton M. Gersony
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Babies and Children's Hospital, Columbia University College of Physicians and Surgeons, New York, NY, USA
Donald L. King
Affiliation:
Department of Medicine, Division of Cardiology, Columbia University College of Physicians and Surgeons, New York, NY, USA
*
Howard D. Apfel, MD. Division of Pediatric Cardiology, Babies and Children's Hospital, Columbia University, 3959 Broadway, New York, NY 10032. Tel: (212) 305–6542. Fax: (212) 305-4429
Get access Rights & Permissions [Opens in a new window]

Absract

The structural complexity of the right ventricle has made quantitative evaluation difficult. Conventional cross-sectional echocardiographic methods are limited by geometric assumptions and the position of the planes used for imaging. Previous reports have demonstrated accurate three-dimensional echocardiographic quantitation of the right ventricle in-vitro and in experimental animals. We adapted a previously described method for three-dimensional reconstruction of the left ventricle to compute right ventricular volume and ejection fraction in a clinical setting.

We examined 29 patients aged from 2 to 42 years with pulmonary hypertension, by three-dimensional echocardiography and resonance imaging. Correlation and agreement were calculated for volumes and ejection fractions. Three-dimensional echocardiographic reconstruction, when compared to resonance imaging, yielded r values of 0.95 and 0.93, and mean differences (bias) of 31% ± 19% and 33% ± 18%, for systolic and diastolic volumes respectively. Interobserver variability was low (12.9% and 8.0%). Ejection fraction as calculated by three-dimensional echocardiography showed close agreement with resonance images (bias=l% ±7%). Three dimensional echocardiography is now a method of measuring right ventricular ejection fraction in the clinical setting which produces results comparable to those of resonance imaging. Volume measurements correlated well for systole and diastole, but consistently underestimated values produced from resonance images.

Keywords

Echocardiographyheart function testsimage processingpulmonary hypertensionright ventricle
Type
Original Articles
Information
Cardiology in the Young , Volume 7 , Issue 3 , July 1997 , pp. 317 - 324
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Konstam, MA, Idoine, J, Wynne, J, Grossman, W, Cohn, L, Beck, JR, Kozlowski, J, Holman, BL. Right ventricular function in adults with pulmonary hypertension with and without atrial septal defect. Am J Cardiol 1983;51: 1144–1148.CrossRefGoogle ScholarPubMed
2.Hoffman, MJ, Greenfield, LS, Sugerman, HJ. Unsuspected right ventricular dysfunction in shock and sepsis. Ann Surg 1983;3:307–319.CrossRefGoogle Scholar
3.Fuster, V, McGoon, DC, Kennedy, MA. Long-term evaluation of open heart surgery for tetralogy of Fallot. Am J Cardiol 1980;46:635–642.CrossRefGoogle ScholarPubMed
4.Redington, AN, Rigby, ML, Oldershaw, PJ, Gibson, DG, Shinebourne, EA. Right ventricular function 10 years after the Mustard operation for transposition of the great arteries: analysis of size, shape and wall motion. Br Heart J 1989;62:455–461.CrossRefGoogle ScholarPubMed
5.Reiter, SJ, Rumberger, JA, Feiring, AJ, Stanford, W, Marcus, ML. Precision of measurements of right and left ventricular volume by cine computed tomography. Circulation 1986;74:890–900.CrossRefGoogle ScholarPubMed
6.Mahoney, LT, Smith, W, Noel, MP, Florentin, M, Skorton, DJ, Collins, SM. Measurement of right ventricular volume using cine computer tomography. Invest Radiol 1987;22:451–455.Google Scholar
7.Marzullo, P, L'Abbate, A, Marcus, M. Patterns of global and regional systolic and diastolic function in the normal right ventricle assessed by ultrafast computed tomography. J Am Coll Cardiol 1991;17:1318–1325.CrossRefGoogle ScholarPubMed
8.Boxt, LM, Kate, J, Czegledy, F, Barst, RJ. Direct quantitation of right and left ventricular volumes using nuclear magnetic resonance imaging in patients with primary pulmonary hypertension. J Am Coll Cardiol 1992;19:1508–1515.CrossRefGoogle ScholarPubMed
9.Sechtem, U, Pflugfelder, PW, Gould, PG, Cassidy, MM, Higins, CB. Measurement of right and left ventricular volumes in healthy individuals with cine MR imaging. Radiology 1987;163:697–702.CrossRefGoogle ScholarPubMed
10.Mogelrang, J, Stubgaard, M, Thomsen, C, Henniksen, O. Evaluation of right ventricular volumes measured by magnetic resonance imaging. Eur Heart J 1988;9:529–533.Google Scholar
11.Kaul, S, Boucher, CA, Okada, RD. Sources of variability in the radionuclide angiocardiographic assessment of ejection fraction: a comparison of first–pass and gated equilibrium techniques. Am J Cardiol 1984;53:83–89.CrossRefGoogle Scholar
12.Morrison, DA, Turgeon, J, Ovit, T. Right ventricular assessment. Ejection fraction measurement: Contrast ventriculoraphy versus gated blood pool and gated first-pass radionuclide mthods. Am J Cardiol 1984,54:651–658.CrossRefGoogle Scholar
13.Jain, D, Zaret, BL. Assessment of right ventricular function. Role of nuclear imaging techniques. Cardiol Clin 1992;10: 23–39.Google Scholar
14.Starling, MR, Crawford, MH, Sorenson, SG, O'Rourke, A. A new two-dimensional echocardiographic technique for evaluating right ventricular size and performance in patients with obstructive lung disease. Circulation 1982;66:612–620.Google Scholar
15.Wantabe, T, Katsume, H, Matsukubo, H, Furukawa, K, Ijichi, H. Estimation of right ventricular volume with two-dimensional echocardiography. Am J Cardiol 1982;49: 1946–1953.Google Scholar
16.Silverman, NH, Hudson, S. Evaluation of right ventricular volume and ejection fraction in children by two-dimensional echocardiography. Ped Cardiol 1983;4:197–204.CrossRefGoogle ScholarPubMed
17.Aebischer, NM, Ferenc, C. Determination of right ventricular volume by two-dimensional echocardiography with a crescentic model. J Am Soc Echo 1989;2:110–118.CrossRefGoogle ScholarPubMed
18.Levine, RA, Gibson, TC, Aretz, T, Gillam, LD, Guyer, DE, King, ME, Weyman, AE. Echocardiograpic measurement of right ventricular volume. Circulation 1984;69:497–505.CrossRefGoogle Scholar
19.Apfel, HD, Solowiejczyk, DE, Challenger, M, Boxt, LM, Barst, RJ, Gersony, WG. Feasibility of a two - dimensional echocardiographic method for the clinical of assessment of right ventricular volume and function in children. J Am Soc of Echo 1996; 9(5): 637–644CrossRefGoogle ScholarPubMed
20.King, DL, King, DL Jr., Shao, MYC. Three- dimensional spatial registration and interactive display of position and orientation of real-time ultrasound images. J Ultrasound Med 1990;9:525–532.Google Scholar
21.Gopal, AS, Shen, Z, Sapin, PM, Olakymbaye, M, Schnellbacher, M, Blood, D, Leibowitz, D, King, DL. Assessment of cardiac function by three-dimensional echocardiography compared to conventional non-invasive methods. Circulation 1995; 92(4):842.CrossRefGoogle Scholar
22.Apfel, HD, Shen, Z, Gopal, AS, Vangi, V, Solowiejczyk, DE, Altmann, K, Barst, RJ, Boxt, LM, Allan, LD, King, DL. Quantitative three-dimensional echocardiography in patients with pulmonary hypertension and compressed left ventricles: comparison to two-dimensional echocardiography and magnetic resonance imaging. Heart J 1996; 76: 352–359Google ScholarPubMed
23.Linker, DT, Moritz, WE, Pearlman, AS. A new three-dimensional echocardiographic method of right ventricular volume measurement: in vitro validation. J Am Coll Cardiol 1986;8:101–106.Google Scholar
24.Jiang, L, Handschumacher, MD, Hibberd, MG, Siu, S, King, ME, Picerd, MH, Weyman, AE, Levine, RA. Three dimensional echocardiographic reconstruction of right ventricular volume: in vitro comparison with two dimensional methods. J Am Soc of Echo 1994;7(2):150–158.CrossRefGoogle ScholarPubMed
25.Jiang, L, Siu, S, Handschumacher, MD, Guererro, JL, de Vasquez Prada, JA, King, ME, Picerd, MH, Weyman, AE, Levine, RA. Three-dimensional echocardiography. In vivo validation for right ventricular volume and function. Circulation 1994;89:2342–2350.CrossRefGoogle ScholarPubMed
26.Bland, JM, Altman, DG. Statistical methods for assessing agreement between two methods of clinical measurment. Lancet 1986;1:307–310.CrossRefGoogle Scholar
27.Naik, MM, Diamond, GA, Pai, T, Soffer, A, Siegel, RJ. Correspondence of left ventricular ejection fraction determinations from two-dimensional echocardiography, radionuclide angiography, and contrast cineangiography. J Am Coll Cardiol 1995;25:937–942.Google Scholar