Comparison of novel echocardiographic parameters of right ventricular function with ejection fraction by cardiac magnetic resonance.
BACKGROUND
Assessment of right ventricular (RV) function by echocardiography is challenging. Newer techniques such as tissue Doppler echocardiography and strain echocardiography may allow accurate and quantitative assessment of RV function. We sought to determine which echocardiographic variable or variables best correlated with RV ejection fraction (RVEF) by cardiac magnetic resonance.


METHODS
We performed conventional echocardiography, tissue Doppler echocardiography, strain echocardiography, and cardiac magnetic resonance on 53 individuals, of which 10 patients had arrhythmogenic RV dysplasia without pulmonary hypertension, and 43 were control subjects. RV fractional area change (FAC), Tei index, isovolumic acceleration, peak systolic velocity (S'), tissue displacement, systolic strain (Ss) rate, and Ss were measured.


RESULTS
RVEF, FAC, S', tissue displacement, isovolumic acceleration, Ss rate, and Ss were significantly lower in patients compared with control subjects (P < or = .05 in all) but not the Tei index (P = .07). Regression analysis revealed a significant correlation between S', tissue displacement, Ss rate, Ss, and FAC with RVEF (P < .05 for all) but not with isovolumic acceleration and Tei index (P = .13 and .39, respectively). Multivariate analysis demonstrated a persistent significant relationship between S' and FAC with RVEF (both P < .05). However, feasibility, and intraobserver and interobserver agreement, were substantially lower for FAC. A cut-off value of 8.8 cm/s for S' had sensitivity and specificity of 80% and 79% (area under the curve 0.87, P = .01), respectively, for prediction of RVEF less than 45%.


CONCLUSIONS
Tissue Doppler echocardiographically derived S' best correlates with cardiac magnetic resonance-derived RVEF with high reproducibility and may facilitate simple and quantitative assessment of RV function.
Wang
Jianwen
J
Division of Cardiology, The Johns Hopkins University, Baltimore, Maryland, USA.
Prakasa
Kalpana
K
Bomma
Chandra
C
Tandri
Harikrishna
H
Dalal
Darshan
D
James
Cynthia
C
Tichnell
Crystal
C
Corretti
Mary
M
Bluemke
David
D
Calkins
Hugh
H
Abraham
Theodore P
TP
D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D002306:Cardiac Volume; D016009:Chi-Square Distribution; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016278:Ventricular Function, Right