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This Article Full Text (PDF) Free All Versions of this Article: chest.06-2143v1 131/6/1844    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Jenkins, C. Articles by Marwick, T. H Search for Related Content PubMed PubMed Citation Articles by Jenkins, C. Articles by Marwick, T. H

Reproducibility of Right Ventricular Volumes and Ejection Fraction using Real-Time 3D Echo; Comparison with Cardiac MRI

University of Queensland, Brisbane, Australia

tmarwick{at}soms.uq.edu.au

Abstract

ObjectivesThe non-geometric nature of the right ventricle (RV) makes it difficult to measure. We sought whether real-time 3D echo (RT3D) is superior to 2D echo (2DE) for follow-up of RV function by validation vs. cardiac MRI.

MethodsRV volumes and EF were studied with 2DE (including area-length (A-L), modified subtraction method (2DS) and Simpson's method of discs), RT3D and magnetic resonance imaging (MRI) in 50 patients with left ventricular wall motion abnormalities that suggested possible RV infarction. Test-retest variation was performed by a complete re-study by a separate sonographer within 24 hours without alteration of hemodynamics or therapy. Inter- and intra-observer variation was performed on a subgroup of 20 patients.

ResultsEF estimations were similar with each technique. The MRI end-diastolic volume (EDV; 87±22 ml) was only slightly underestimated by RT3D (mean difference, -3±10 p<0.05), with greater mean difference with 2DE A-L (-29±10 p<0.05), and Simpson's (-29±23 p<0.05) and greatly overestimated by 2DS (mean difference, 26±23 p<0.05). Similarly, MRI end-systolic volume (ESV; 46±17 ml) was only slightly underestimated by RT3D (-4±7 p<0.05), compared with 2DE A-L (-16±8 p<0.05) and Simpson's (-16±8 p<0.05) and overestimated by 2DS (14±13 p<0.05). RT3D had higher correlation with each parameter than any 2DE technique. There was also good intra- and inter-observer correlation between RT3D by two sonographers. RT3D had less test-retest variation of RV volumes and EF than any 2DE measure.

ConclusionsRT3D more accurate than 2D approaches and reduces test-retest variation of RV volumes and EF measurements in follow-up RV assessment.

Key Words: Right ventricle • volumes • ejection fraction • 2-dimensional echocardiography • real-time 3-dimensional echocardiography