Accuracy of guideline recommendations for two-dimensional quantification of the right ventricle by echocardiography.
BACKGROUND
The accuracy of the guidelines of the American Society of Echocardiography (ASE) for the two-dimensional (2D) quantitative assessment of right ventricular (RV) size and function has not been evaluated against MRI-derived RV volumes in patients with congenital heart disease and RV volume overload.


METHODS
Three groups of patients were studied: a normal RV group (Group I, n = 31), a repaired tetralogy of Fallot group (Group II, n = 33), and an unrepaired atrial septal defect and/or partially anomalous pulmonary venous connection group (Group III, n = 23). Recommended 2D linear and cross-sectional area measurements were made on clinical echocardiographic and MRI studies performed less than 6 months apart.


RESULTS
Most 2D RV parameters were smaller by echocardiography versus MRI. There was weak correlation between 2D RV measurements by echocardiography and MRI-derived RV volumes (Group I: r = 0.15-0.54, Group II: r = 0.33-0.61, Group III: r = 0.32-0.85), and only modest improvement when the same 2D measurements were performed by MRI (Group I: r = 0.37-0.61, Group II: r = 0.44-0.69, Group III: r = 0.28-0.74). The difference between 2D RV measurements by echocardiography and MRI-derived RV volumes was more pronounced in the RV volume overload groups.


CONCLUSIONS
The correlation between currently recommended 2D RV measurements by echocardiography and MRI-derived RV volumes was weak, and improved only modestly when MRI was used to make the same 2D measurements. Moreover, 2D echocardiographic assessment of the RV appears to be less accurate in patients with congenital heart disease and a dilated RV.
Lai
Wyman W
WW
Department of Cardiology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA.
Gauvreau
Kimberlee
K
Rivera
Ernesto S
ES
Saleeb
Susan
S
Powell
Andrew J
AJ
Geva
Tal
T
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler / Q000379:methods; D006330:Heart Defects, Congenital / Q000150:complications; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D017410:Practice Guidelines as Topic / Q000592:standards*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology; D055815:Young Adult