Quantification of Right Ventricular Volume and Function Using Single-Beat Three-Dimensional Echocardiography: A Validation Study with Cardiac Magnetic Resonance
Quantification of Right Ventricular Volume and Function Using Single-Beat Three-Dimensional Echocardiography: A Validation Study with Cardiac Magnetic Resonance
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DOI：
10.1016/j.echo.2016.01.010
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发表时间：
2016-05-01
影响因子：
6.5
通讯作者：
Sohn, Dae-Won
中科院分区：
文献类型：
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作者：
Park, Jun-Bean;Lee, Seung-Pyo;Sohn, Dae-Won
背景：由于右心室独特的几何结构，右心室（RV）容量和功能的评估在临床上具有挑战性。本研究的目的是探讨单拍三维超声心动图（sb 3DE）的右室容积和功能的评估在右室扩张patients.Methods：52例严重三尖瓣返流或房间隔缺损患者入组。50例患者在正常血容量状态下24小时内进行了sb 3DE和心脏磁共振（CMR），并将sb 3DE的结果与参考方法CMR的结果进行了比较。15名正常受试者也被招募为sb3DE.Results的更广泛的验证，从59个研究参与者（44例患者和15名正常受试者）的数据进行了分析，具有足够的图像质量（平均年龄，46.9 +/- 19.3岁; 58%的女性）。sb 3DE和CMR测量RV容积和RV射血分数（RVEF）的相关性非常好（RV舒张末期容积、RV收缩末期容积和RVEF分别为r = 0.96、r = 0.93和r = 0.93 [P均<0.001]）。Bland-Altman分析显示，sb 3DE倾向于略微低估右心室容积（右心室舒张末期容积、右心室收缩末期容积和右心室射血分数分别为-5.8 +/-9.6%、-3.8 +/-14.1%和-1.2 +/- 9.4%），但不低估右心室射血分数。所有指标的观察者内和观察者间变异性均可接受（RV舒张末期容积分别为4.9%和6.1%，RV收缩末期容积分别为4.2%和7.9%，RVEF分别为5.7%和2.8%）。在右室扩张的患者中，房颤患者sb 3DE和CMR的RVEF差异比窦性心律患者更明显（-5.9%vs0.9%，P = 0.041）。结论：在右室扩张患者和正常人中，sb 3DE评估右室容积和收缩功能在准确性和可重复性方面是可行的。房颤患者可使用sb 3DE进行RV分析，但可能会低估RVEF。
Background: Because of the unique geometry of the right ventricle, assessment of right ventricular (RV) volume and function is clinically challenging. The aim of this study was to investigate the feasibility of single-beat three-dimensional echocardiography (sb3DE) for RV volume and functional assessment in patients with dilated right ventricles.Methods: Fifty-two patients with severe tricuspid regurgitation or atrial septal defects were enrolled. Fifty patients underwent sb3DE and cardiac magnetic resonance (CMR) within 24 hours under a euvolemic state, and the results of sb3DE were compared with those of CMR, the reference method. Fifteen normal subjects were also recruited for a broader validation of sb3DE.Results: Of the 67 individuals, data from 59 study participants (44 patients and 15 normal subjects) with adequate image quality were analyzed (mean age, 46.9 +/- 19.3 years; 58% women). The correlation was excellent between sb3DE and CMR for measuring RV volumes and RV ejection fraction (RVEF) (r = 0.96, r = 0.93, and r = 0.93 [P < .001 for all] for RV end-diastolic volume, RV end-systolic volume, and RVEF, respectively). Bland-Altman analysis revealed that RV volumes, but not RVEF, tended to be slightly underestimated by sb3DE (-5.8 +/- 9.6%, -3.8 +/- 14.1%, and -1.2 +/- 9.4% for RV end-diastolic volume, RV end-systolic volume, and RVEF, respectively). Intra-and interobserver variability was acceptable for all indices (4.9% and 6.1% for RV end-diastolic volume, 4.2% and 7.9% for RV end-systolic volume, and 5.7% and 2.8% for RVEF, respectively). Among patients with RV dilation, the difference in RVEF between sb3DE and CMR was more pronounced in patients with atrial fibrillation than those in sinus rhythm (-5.9% vs 0.9%, P = .041).Conclusions: In patients with dilated right ventricles and in normal subjects, assessment of RV volume and systolic function by sb3DE is feasible in terms of accuracy and reproducibility. RV analysis using sb3DE can be performed in patients with atrial fibrillation, with the possibility of RVEF underestimation.