title: Advantages of real time three-dimensional echocardiography in the assessment of right ventricular volumes and function in patients with pulmonary hypertension compared with conventional two-dimensional echocardiography.
abstract: BACKGROUND
  In recent years, right ventricular (RV) function has acquired greater relevance as a clinical and prognostic marker in many physiopathological conditions. The study aims to point out the value of real time three-dimensional echocardiography (RT3DE) and tissue Doppler imaging (TDI) in the evaluation of patients affected by pulmonary hypertension (PH), compared with conventional two-dimensional (2D) echocardiography.
  
  
  METHODS
  We enrolled 44 subjects affected by PH who underwent 2D and Doppler echocardiography, RT 3D Echocardiography and TDI evaluation of the RV, and a healthy control group. PH itself can induce severe functional and structural abnormalities of the RV, such as RV hypertrophy, RV dilation, and RV systolic and diastolic dysfunction.
  
  
  RESULTS
  In this study, RV FAC, and TAPSE showed marked alterations in patients with PH compared to the control group (C): (RVFAC: [PH] 0.29 ± 0.07 vs. [C] 0.49 ± 0.05%, P < 0.0001; TAPSE: [PH] 15.3 ± 3.2 vs. [C] 21.1 ± 2.6 mm, P > 0.0001). The 3D RV end-diastolic volume was significantly higher in PH than in C (PH) (138.7 ± 25.3 vs. [C] 82.8 ± 12.5 mL, P < 0.0001] as well as 3D RV end-systolic volume (PH) (97.6 ± 21.5 vs. [C] 39.3 ± 9.5 mL, P < 0.0001). The 3D RV ejection fraction (EF) was significantly lower in the pulmonary hypertension group than in healthy subjects (31.8 ± 6.8 vs. [C] 52.5 ± 4.7%, P < 0.0001).
  
  
  CONCLUSIONS
  In patients with PH, evaluation of the RV diastolic and systolic volume and EF by RT3DE has shown a higher discriminating power in comparison, respectively, with 2DRV diastolic area and the relative fractional area changes.
authors.affiliation: Cardiac Thoracic and Vascular Department, University of Pisa, Pisa, Italy. vitantonio.dibello@med.unipi.it
authors.forename: Vitantonio
authors.initials: V
authors.lastname: Di Bello
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Conte
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Delle Donne
authors.forename: Cristina
authors.initials: C
authors.lastname: Giannini
authors.forename: Valentina
authors.initials: V
authors.lastname: Barletta
authors.forename: Iacopo
authors.initials: I
authors.lastname: Fabiani
authors.forename: Caterina
authors.initials: C
authors.lastname: Palagi
authors.forename: Carmela
authors.initials: C
authors.lastname: Nardi
authors.forename: Frank Lloyd
authors.initials: FL
authors.lastname: Dini
authors.forename: Letizia
authors.initials: L
authors.lastname: Marconi
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Paggiaro
authors.forename: Antonio
authors.initials: A
authors.lastname: Palla
authors.forename: Mario
authors.initials: M
authors.lastname: Marzilli
mesh_terms: D003199:Computer Systems; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging*; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000000981:diagnostic imaging*
keywords: Real time 3D echocardiography; pulmonary hypertension