Three-dimensional assessment of two-dimensional technique for evaluation of right ventricular function by tricuspid annulus motion.
BACKGROUND
Measurement of tricuspid annulus motion (TAM) is an easy way to estimate right ventricular ejection fraction (RVEF). However the accuracy of two-dimensional (2-D) methods for analyzing the three-dimensional (3-D) structure of the tricuspid annulus has not been evaluated.


OBJECTIVE
This study evaluated the accuracy with which 2-D measurements of TAM reflect RVEF using 3-D reconstructions of the heart at end diastole (ED) and end systole (ES).


METHODS
2-D echocardiographic studies were performed on 12 subjects and used to reconstruct the RV and tricuspid annulus in 3-D at ED and ES. Measurements of TAM from medial and lateral positions on the annulus were selected from the standard echocardiographic apical four-chamber view. The minimum and maximum possible TAM values, RV volumes, and movement of the apex of the heart along the trajectory of TAM were calculated from the 3-D reconstructions.


RESULTS
TAM correlated highly with RVEF (r > or = 0.90). Values found by 2-D and 3-D techniques were not significantly different. Correcting TAM for apex motion did not improve correlation. Summation of medial and lateral TAM data increased correlation values slightly relative to lateral TAM alone. Regional aberrant contractility degraded the predictive value of TAM.


CONCLUSIONS
Estimation of RVEF from 2-D echo measurement of TAM is accurate, especially when medial and lateral TAM are summed, except in patients with severe apical RV dysfunction.
Smith
Jordan L
JL
Cardiovascular Research and Training Center, University of Washington, Seattle, WA, USA.
Bolson
Edward L
EL
Wong
Selwyn P
SP
Hubka
Michal
M
Sheehan
Florence H
FH
D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000503:physiopathology; D015150:Echocardiography, Doppler; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology; D009200:Myocardial Contraction / Q000502:physiology; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D013223:Statistics as Topic; D013318:Stroke Volume / Q000502:physiology; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000502:physiology*; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000503:physiopathology; D016276:Ventricular Function; D016278:Ventricular Function, Right / Q000502:physiology*; D014861:Washington