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Erschienen in: Clinical Research in Cardiology 3/2013

01.03.2013 | Original Paper

Non-invasive quantification of right ventricular systolic function by echocardiography: a new semi-automated approach

verfasst von: Sebastian Greiner, Florian André, Melissa Heimisch, Alexander Heß, Henning Steen, Hugo A. Katus, Derliz Mereles

Erschienen in: Clinical Research in Cardiology | Ausgabe 3/2013

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Abstract

Background

Right ventricular (RV) function determines long-term outcome in many cardiopulmonary diseases. However, the assessment of RV function is time-consuming and surrogate parameters derived from two-dimensional (2D) or Doppler echocardiography show poor consistency.

Methods

Forty consecutive patients were examined within 30 min after magnetic resonance imaging (MRI) with comprehensive echocardiography, including strain imaging and real-time three-dimensional echocardiography. A new parameter, the RV automated systolic index (RV-ASI), was obtained from the apical four-chamber view using semi-automated border detection.

Results

RV-ASI could be assessed by 2D echocardiography in 38 of 40 patients. RV ejection fraction assessed by MRI was 48 ± 9 %, while RV-ASI was 52 ± 11 % (r = 0.74, SEE = 6 %, p < 0.0001). Intra- and inter-observer variabilities were 7.5 and 8.9 %, respectively. An RV-ASI cut-off value of 52 % in this cohort was able to differentiate between normal and impaired RV function (AUC 0.92, sensitivity 87 %, specificity 93 %).

Conclusions

In this study, the RV-ASI showed to be an easy, rapid to assess and reliable tool for quantification of right ventricular function. Furthermore, this index can complement the assessment of right ventricular mechanics by 2D strain imaging for efficient and comprehensive non-invasive evaluation of right ventricular function.
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Literatur
1.
Zurück zum Zitat Grünig E, Janssen B, Mereles D, Barth U, Borst MM, Vogt IR, Fischer C, Olschewski H, Kuecherer HF, Kübler W (2000) Abnormal pulmonary artery pressure response in asymptomatic carriers of primary pulmonary hypertension gene. Circulation 102:1145–1150PubMedCrossRef Grünig E, Janssen B, Mereles D, Barth U, Borst MM, Vogt IR, Fischer C, Olschewski H, Kuecherer HF, Kübler W (2000) Abnormal pulmonary artery pressure response in asymptomatic carriers of primary pulmonary hypertension gene. Circulation 102:1145–1150PubMedCrossRef
2.
Zurück zum Zitat Grünig E, Weissmann S, Ehlken N, Fijalkowska A, Fischer C, Fourme T, Galié N, Ghofrani A, Harrison RE, Huez S, Humbert M, Janssen B, Kober J, Koehler R, Machado RD, Mereles D, Naeije R, Olschewski H, Provencher S, Reichenberger F, Retailleau K, Rocchi G, Simonneau G, Torbicki A, Trembath R, Seeger W (2009) Stress Doppler echocardiography in relatives of patients with idiopathic and familial pulmonary arterial hypertension: results of a multicenter European analysis of pulmonary artery pressure response to exercise and hypoxia. Circulation 119:1747–1757PubMedCrossRef Grünig E, Weissmann S, Ehlken N, Fijalkowska A, Fischer C, Fourme T, Galié N, Ghofrani A, Harrison RE, Huez S, Humbert M, Janssen B, Kober J, Koehler R, Machado RD, Mereles D, Naeije R, Olschewski H, Provencher S, Reichenberger F, Retailleau K, Rocchi G, Simonneau G, Torbicki A, Trembath R, Seeger W (2009) Stress Doppler echocardiography in relatives of patients with idiopathic and familial pulmonary arterial hypertension: results of a multicenter European analysis of pulmonary artery pressure response to exercise and hypoxia. Circulation 119:1747–1757PubMedCrossRef
4.
Zurück zum Zitat Haddad F, Doyle R, Murphy DJ, Hunt SA (2008) Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation 117:1717–1731PubMedCrossRef Haddad F, Doyle R, Murphy DJ, Hunt SA (2008) Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation 117:1717–1731PubMedCrossRef
5.
Zurück zum Zitat Voelkel NF, Quaife RA, Leinwand LA, Barst RJ, McGoon MD, Meldrum DR, Dupuis J, Long CS, Rubin LJ, Smart FW, Suzuki YJ, Gladwin M, Denholm EM, Gail DB (2006) Right ventricular function and failure: report of a national heart, lung, and blood institute working group on cellular and molecular mechanisms of right heart failure. Circulation 114:1883–1891PubMedCrossRef Voelkel NF, Quaife RA, Leinwand LA, Barst RJ, McGoon MD, Meldrum DR, Dupuis J, Long CS, Rubin LJ, Smart FW, Suzuki YJ, Gladwin M, Denholm EM, Gail DB (2006) Right ventricular function and failure: report of a national heart, lung, and blood institute working group on cellular and molecular mechanisms of right heart failure. Circulation 114:1883–1891PubMedCrossRef
6.
Zurück zum Zitat Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American society of echocardiography endorsed by the european association of echocardiography, a registered branch of the european society of cardiology, and the canadian society of echocardiography. J Am Soc Echocardiogr 23:685–713PubMedCrossRef Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American society of echocardiography endorsed by the european association of echocardiography, a registered branch of the european society of cardiology, and the canadian society of echocardiography. J Am Soc Echocardiogr 23:685–713PubMedCrossRef
7.
Zurück zum Zitat Borges AC, Knebel F, Eddicks S, Panda A, Schattke S, Witt C, Baumann G (2006) Right ventricular function assessed by two-dimensional strain and tissue Doppler echocardiography in patients with pulmonary arterial hypertension and effect of vasodilator therapy. Am J Cardiol 98:530–534PubMedCrossRef Borges AC, Knebel F, Eddicks S, Panda A, Schattke S, Witt C, Baumann G (2006) Right ventricular function assessed by two-dimensional strain and tissue Doppler echocardiography in patients with pulmonary arterial hypertension and effect of vasodilator therapy. Am J Cardiol 98:530–534PubMedCrossRef
8.
Zurück zum Zitat Tamborini G, Brusoni D, Torres Molina JE, Galli CA, Maltagliati A, Muratori M, Susini F, Colombo C, Maffessanti F, Pepi M (2008) Feasibility of a new generation three-dimensional echocardiography for right ventricular volumetric and functional measurements. Am J Cardiol 102:499–505PubMedCrossRef Tamborini G, Brusoni D, Torres Molina JE, Galli CA, Maltagliati A, Muratori M, Susini F, Colombo C, Maffessanti F, Pepi M (2008) Feasibility of a new generation three-dimensional echocardiography for right ventricular volumetric and functional measurements. Am J Cardiol 102:499–505PubMedCrossRef
9.
Zurück zum Zitat Rich JD, Shah SJ, Swamy RS, Kamp A, Rich S (2011) Inaccuracy of Doppler echocardiographic estimates of pulmonary artery pressures in patients with pulmonary hypertension: implications for clinical practice. Chest 139:988–993PubMedCrossRef Rich JD, Shah SJ, Swamy RS, Kamp A, Rich S (2011) Inaccuracy of Doppler echocardiographic estimates of pulmonary artery pressures in patients with pulmonary hypertension: implications for clinical practice. Chest 139:988–993PubMedCrossRef
10.
Zurück zum Zitat Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18:1440–1463PubMedCrossRef Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18:1440–1463PubMedCrossRef
11.
Zurück zum Zitat Rajagopalan N, Simon MA, Mathier MA, Lopez-Candales A (2008) Identifying right ventricular dysfunction with tissue Doppler imaging in pulmonary hypertension. Int J Cardiol 128:359–363PubMedCrossRef Rajagopalan N, Simon MA, Mathier MA, Lopez-Candales A (2008) Identifying right ventricular dysfunction with tissue Doppler imaging in pulmonary hypertension. Int J Cardiol 128:359–363PubMedCrossRef
12.
Zurück zum Zitat Sato T, Tsujino I, Ohira H, Oyama-Manabe N, Yamada A, Ito YM, Goto C, Watanabe T, Sakaue S, Nishimura M (2012) Validation study on the accuracy of echocardiographic measurements of right ventricular systolic function in pulmonary hypertension. J Am Soc Echocardiogr 25:280–286PubMedCrossRef Sato T, Tsujino I, Ohira H, Oyama-Manabe N, Yamada A, Ito YM, Goto C, Watanabe T, Sakaue S, Nishimura M (2012) Validation study on the accuracy of echocardiographic measurements of right ventricular systolic function in pulmonary hypertension. J Am Soc Echocardiogr 25:280–286PubMedCrossRef
13.
Zurück zum Zitat Leong DP, Grover S, Molaee P, Chakrabarty A, Shirazi M, Cheng YH, Penhall A, Perry R, Greville H, Joseph MX, Selvanayagam JB (2012) Nonvolumetric echocardiographic indices of right ventricular systolic function: validation with cardiovascular magnetic resonance and relationship with functional capacity. Echocardiography 29:455–463PubMedCrossRef Leong DP, Grover S, Molaee P, Chakrabarty A, Shirazi M, Cheng YH, Penhall A, Perry R, Greville H, Joseph MX, Selvanayagam JB (2012) Nonvolumetric echocardiographic indices of right ventricular systolic function: validation with cardiovascular magnetic resonance and relationship with functional capacity. Echocardiography 29:455–463PubMedCrossRef
14.
Zurück zum Zitat Filusch A, Mereles D, Gruenig E, Buss S, Katus HA, Meyer FJ (2010) Strain and strain rate echocardiography for evaluation of right ventricular dysfunction in patients with idiopathic pulmonary arterial hypertension. Clin Res Cardiol 99:491–498PubMedCrossRef Filusch A, Mereles D, Gruenig E, Buss S, Katus HA, Meyer FJ (2010) Strain and strain rate echocardiography for evaluation of right ventricular dysfunction in patients with idiopathic pulmonary arterial hypertension. Clin Res Cardiol 99:491–498PubMedCrossRef
15.
Zurück zum Zitat Giusca S, Dambrauskaite V, Scheurwegs C, D’hooge J, Claus P, Herbots L, Magro M, Rademakers F, Meyns B, Delcroix M, Voigt JU (2010) Deformation imaging describes right ventricular function better than longitudinal displacement of the tricuspid ring. Heart 96:281–288PubMedCrossRef Giusca S, Dambrauskaite V, Scheurwegs C, D’hooge J, Claus P, Herbots L, Magro M, Rademakers F, Meyns B, Delcroix M, Voigt JU (2010) Deformation imaging describes right ventricular function better than longitudinal displacement of the tricuspid ring. Heart 96:281–288PubMedCrossRef
16.
Zurück zum Zitat Puwanant S, Park M, Popović ZB, Tang WH, Farha S, George D, Sharp J, Puntawangkoon J, Loyd JE, Erzurum SC, Thomas JD (2010) Ventricular geometry, strain, and rotational mechanics in pulmonary hypertension. Circulation 121:259–266PubMedCrossRef Puwanant S, Park M, Popović ZB, Tang WH, Farha S, George D, Sharp J, Puntawangkoon J, Loyd JE, Erzurum SC, Thomas JD (2010) Ventricular geometry, strain, and rotational mechanics in pulmonary hypertension. Circulation 121:259–266PubMedCrossRef
17.
Zurück zum Zitat Raymond RJ, Hinderliter AL, Willis PW, Ralph D, Caldwell EJ, Williams W, Ettinger NA, Hill NS, Summer WR, de Boisblanc B, Schwartz T, Koch G, Clayton LM, Jöbsis MM, Crow JW, Long W (2002) Echocardiographic predictors of adverse outcomes in primary pulmonary hypertension. J Am Coll Cardiol 39:1214–1219PubMedCrossRef Raymond RJ, Hinderliter AL, Willis PW, Ralph D, Caldwell EJ, Williams W, Ettinger NA, Hill NS, Summer WR, de Boisblanc B, Schwartz T, Koch G, Clayton LM, Jöbsis MM, Crow JW, Long W (2002) Echocardiographic predictors of adverse outcomes in primary pulmonary hypertension. J Am Coll Cardiol 39:1214–1219PubMedCrossRef
18.
Zurück zum Zitat Leibundgut G, Rohner A, Grize L, Bernheim A, Kessel-Schaefer A, Bremerich J, Zellweger M, Buser P, Handke M (2010) Dynamic assessment of right ventricular volumes and function by real-time three-dimensional echocardiography: a comparison study with magnetic resonance imaging in 100 adult patients. J Am Soc Echocardiogr 23:116–126PubMedCrossRef Leibundgut G, Rohner A, Grize L, Bernheim A, Kessel-Schaefer A, Bremerich J, Zellweger M, Buser P, Handke M (2010) Dynamic assessment of right ventricular volumes and function by real-time three-dimensional echocardiography: a comparison study with magnetic resonance imaging in 100 adult patients. J Am Soc Echocardiogr 23:116–126PubMedCrossRef
19.
Zurück zum Zitat van der Zwaan HB, Geleijnse ML, McGhie JS, Boersma E, Helbing WA, Meijboom FJ, Roos-Hesselink JW (2011) Right ventricular quantification in clinical practice: two-dimensional vs. three-dimensional echocardiography compared with cardiac magnetic resonance imaging. Eur J Echocardiogr 12:656–664PubMedCrossRef van der Zwaan HB, Geleijnse ML, McGhie JS, Boersma E, Helbing WA, Meijboom FJ, Roos-Hesselink JW (2011) Right ventricular quantification in clinical practice: two-dimensional vs. three-dimensional echocardiography compared with cardiac magnetic resonance imaging. Eur J Echocardiogr 12:656–664PubMedCrossRef
Metadaten
Titel
Non-invasive quantification of right ventricular systolic function by echocardiography: a new semi-automated approach
verfasst von
Sebastian Greiner
Florian André
Melissa Heimisch
Alexander Heß
Henning Steen
Hugo A. Katus
Derliz Mereles
Publikationsdatum
01.03.2013
Verlag
Springer-Verlag
Erschienen in
Clinical Research in Cardiology / Ausgabe 3/2013
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-012-0528-z

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