3D Echo systematically underestimates right ventricular volumes compared to cardiovascular magnetic resonance in adult congenital heart disease patients with moderate or severe RV dilatation

Journal of Cardiovascular Magnetic Resonance

Research

John P Greenwood¹  Ravi Menezes²  Neil Maredia³  Gill Wharton³  John D Thomson³  Jan Forster³  George Ballard³  Andrew M Crean⁴ 

[1] Academic Unit of Cardiovascular Medicine, Leeds General Infirmary, Leeds, UK;Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada;Division of Adult and Pediatric Cardiology, Leeds General Infirmary, Leeds, UK;Division of Medicine (Cardiology), Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada;Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada;

关键词: Right Ventricular;    Cardiovascular Magnetic Resonance;    Right Ventricular Ejection Fraction;    Pulmonary Valve Replacement;    Right Ventricular Volume;   

DOI  :  10.1186/1532-429X-13-78

 received in 2011-03-30, accepted in 2011-12-08,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThree dimensional echo is a relatively new technique which may offer a rapid alternative for the examination of the right heart. However its role in patients with non-standard ventricular size or anatomy is unclear. This study compared volumetric measurements of the right ventricle in 25 patients with adult congenital heart disease using both cardiovascular magnetic resonance (CMR) and three dimensional echocardiography.MethodsPatients were grouped by diagnosis into those expected to have normal or near-normal RV size (patients with repaired coarctation of the aorta) and patients expected to have moderate or worse RV enlargement (patients with repaired tetralogy of Fallot or transposition of the great arteries). Right ventricular end diastolic volume, end systolic volume and ejection fraction were compared using both methods with CMR regarded as the reference standardResultsBland-Altman analysis of the 25 patients demonstrated that for both RV EDV and RV ESV, there was a significant and systematic under-estimation of volume by 3D echo compared to CMR. This bias led to a mean underestimation of RV EDV by -34% (95%CI: -91% to + 23%). The degree of underestimation was more marked for RV ESV with a bias of -42% (95%CI: -117% to + 32%). There was also a tendency to overestimate RV EF by 3D echo with a bias of approximately 13% (95% CI -52% to +27%).ConclusionsStatistically significant and clinically meaningful differences in volumetric measurements were observed between the two techniques. Three dimensional echocardiography does not appear ready for routine clinical use in RV assessment in congenital heart disease patients with more than mild RV dilatation at the current time.

【 授权许可】

CC BY   
© Crean et al; licensee BioMed Central Ltd. 2011