title: Non-invasive quantification of right ventricular systolic function by echocardiography: a new semi-automated approach.
abstract: BACKGROUND
  Right ventricular (RV) function determines long-term outcome in many cardiopulmonary diseases. However, the assessment of RV function is time-consuming and surrogate parameters derived from two-dimensional (2D) or Doppler echocardiography show poor consistency.
  
  
  METHODS
  Forty consecutive patients were examined within 30 min after magnetic resonance imaging (MRI) with comprehensive echocardiography, including strain imaging and real-time three-dimensional echocardiography. A new parameter, the RV automated systolic index (RV-ASI), was obtained from the apical four-chamber view using semi-automated border detection.
  
  
  RESULTS
  RV-ASI could be assessed by 2D echocardiography in 38 of 40 patients. RV ejection fraction assessed by MRI was 48 ± 9 %, while RV-ASI was 52 ± 11 % (r = 0.74, SEE = 6 %, p < 0.0001). Intra- and inter-observer variabilities were 7.5 and 8.9 %, respectively. An RV-ASI cut-off value of 52 % in this cohort was able to differentiate between normal and impaired RV function (AUC 0.92, sensitivity 87 %, specificity 93 %).
  
  
  CONCLUSIONS
  In this study, the RV-ASI showed to be an easy, rapid to assess and reliable tool for quantification of right ventricular function. Furthermore, this index can complement the assessment of right ventricular mechanics by 2D strain imaging for efficient and comprehensive non-invasive evaluation of right ventricular function.
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany. sebastian.greiner@med.uni-heidelberg.de
authors.forename: Sebastian
authors.initials: S
authors.lastname: Greiner
authors.forename: Florian
authors.initials: F
authors.lastname: André
authors.forename: Melissa
authors.initials: M
authors.lastname: Heimisch
authors.forename: Alexander
authors.initials: A
authors.lastname: Hess
authors.forename: Henning
authors.initials: H
authors.lastname: Steen
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.forename: Derliz
authors.initials: D
authors.lastname: Mereles
mesh_terms: D000328:Adult; D000368:Aged; D001331:Automation; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D013318:Stroke Volume; D013599:Systole; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016278:Ventricular Function, Right