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Chest. 2007 Jun;131(6):1844-51. Epub 2007 Mar 30.

Reproducibility of right ventricular volumes and ejection fraction using real-time three-dimensional echocardiography: comparison with cardiac MRI.

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1
University of Queensland, QLD, Australia.

Abstract

OBJECTIVES:

The nongeometric nature of the right ventricle (RV) makes it difficult to measure. We sought to determine whether real-time three-dimensional echocardiography (RT3DE) is superior to two-dimensional echocardiography (2DE) for the follow-up of RV function by validation vs cardiac MRI.

METHODS:

RV volumes and ejection fraction (EF) were studied with 2DE (including area-length [A-L], the modified two-dimensional subtraction [2DS] method, and the Simpson method of discs), RT3DE, and MRI in 50 patients with left ventricular wall motion abnormalities, the results of which suggested possible RV infarction. Test-retest variation was performed by a complete restudy using a separate sonographer within 24 h without the alteration of hemodynamics or therapy. Interobserver and intraobserver variations were noted in a subgroup of 20 patients.

RESULTS:

EF estimations were similar using each technique. The mean (+/- SD) MRI end-diastolic volume (87 +/- 22 mL) was only slightly underestimated by RT3DE (mean difference, -3 +/- 10; p < 0.05), with a greater mean difference for 2DE A-L (-29 +/- 10; p < 0.05), and the Simpson method of discs (-29 +/- 23; p < 0.05), and was greatly overestimated by 2DS (mean difference, 26 +/- 23; p < 0.05). Similarly, the mean MRI end-systolic volume (46 +/- 17 mL) was only slightly underestimated by RT3DE (-4 +/- 7; p < 0.05), compared with 2DE A-L (-16 +/- 8; p < 0.05) and the Simpson method of discs (-16 +/- 8; p < 0.05), and was overestimated by 2DS (14 +/- 13; p < 0.05). RT3DE findings had a higher correlation with each parameter than any 2DE technique. There was also good intraobserver and interobserver correlation between RT3DE by two sonographers. RT3DE had less test-retest variation of RV volumes and EF than any 2DE measure.

CONCLUSIONS:

RT3DE is more accurate than two-dimensional approaches and reduces the test-retest variation of RV volumes and EF measurements in follow-up RV assessment.

PMID:
17400663
DOI:
10.1378/chest.06-2143
[Indexed for MEDLINE]
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