title: Feasibility of a new generation three-dimensional echocardiography for right ventricular volumetric and functional measurements.
abstract: Right ventricular (RV) dimensions and function are of diagnostic and prognostic importance in cardiac disease. Because of the peculiar morphology of the right ventricle, 2-dimensional echocardiography has several limitations in RV evaluation. Recently, new 3-dimensional transthoracic echocardiographic software adapted for RV morphology was introduced. The aims of this study were to evaluate the feasibility of 3-dimensional RV analysis in a large population and to compare and correlate 3-dimensional RV data with classic 2-dimensional and Doppler parameters, including tricuspid annular plane systolic excursion and peak systolic velocity on Doppler tissue imaging, RV fractional shortening area, RV stroke volume (by the Doppler method), and pulmonary arterial systolic pressure. Two hundred subjects were studied: 48 normal controls and 152 patients with valvular heart disease (104 patients), idiopathic dilated cardiomyopathy (20 patients), or pulmonary hypertension (28 patients). The mean times for 3-dimensional acquisition and 3-dimensional reconstruction were 3 +/- 1 and 4 +/- 2 minutes, respectively. Imaging quality was good in most cases (85%). The mean RV diastolic and systolic volumes were 103 +/- 38 and 46 +/- 28 ml, respectively. The RV ejection fraction (RVEF) was correlated negatively with pulmonary arterial systolic pressure and positively with tricuspid annular plane systolic excursion, peak systolic velocity, and fractional shortening area. The pathologic group was characterized by larger RV volumes and lower RVEFs. Three-dimensional echocardiography clearly showed that in the pathologic group, patients with pulmonary hypertension had the largest RV volumes and the lowest RVEFs and that those with idiopathic dilated cardiomyopathy were characterized by RVEFs lower than those of patients with valvular disease. In conclusion, this new quantitative 3-dimensional method to assess RV volumes and function is feasible, relatively simple, and not time consuming. Data obtained with 3-dimensional analysis are well correlated with those obtained by 2-dimensional and Doppler methods and can differentiate normal and pathologic subjects.
authors.affiliation: Centro Cardiologico Monzino, Institute of Cardiology, University of Milan, Milan, Italy. gtamborini@cardiologicomonzino.it
authors.forename: Gloria
authors.initials: G
authors.lastname: Tamborini
authors.forename: Denise
authors.initials: D
authors.lastname: Brusoni
authors.forename: Jorge Eduardo
authors.initials: JE
authors.lastname: Torres Molina
authors.forename: Claudia Agnese
authors.initials: CA
authors.lastname: Galli
authors.forename: Anna
authors.initials: A
authors.lastname: Maltagliati
authors.forename: Manuela
authors.initials: M
authors.lastname: Muratori
authors.forename: Francesca
authors.initials: F
authors.lastname: Susini
authors.forename: Chiara
authors.initials: C
authors.lastname: Colombo
authors.forename: Francesco
authors.initials: F
authors.lastname: Maffessanti
authors.forename: Mauro
authors.initials: M
authors.lastname: Pepi
mesh_terms: D016022:Case-Control Studies; D003971:Diastole; D019560:Echocardiography, Three-Dimensional / Q000295:instrumentation / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D013318:Stroke Volume; D013599:Systole; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016278:Ventricular Function, Right