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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*
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

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.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1997

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