title: Accuracy of a new method for semi-quantitative assessment of right ventricular ejection fraction by cardiovascular magnetic resonance: right ventricular fractional diameter changes.
abstract: OBJECTIVE
  Longitudinal shortening is traditionally considered the predominant part of global right ventricular (RV) systolic function. Less attention has been paid to transverse contraction. The aim of this study was to evaluate RV transverse motion by cardiovascular magnetic resonance (CMR) in a large cohort of patients and to assess its relationship with RV ejection fraction (RVEF).
  
  
  METHODS
  We retrospectively analyzed the CMR scans of 300 patients referred to our center in 2010. RVEF was determined from short axis sequences using the volumetric method. Transverse parameters called RV fractional diameter changes were calculated after measuring RV diastolic and systolic diameters at basal and mid-level in short axis view (respectively FBDC and FMDC). We also measured the tricuspid annular plane systolic excursion (TAPSE) as a longitudinal reference.
  
  
  RESULTS
  Our population was divided into 2 groups according to RVEF. 250 patients had a preserved RVEF (>40%) and 50 had a RV dysfunction (RVEF ≤ 40%). Transverse and longitudinal motions were significantly reduced in the group with RV dysfunction (p<.0001). After ROC analysis, areas under the curve for FBDC, FMDC and TAPSE, were respectively 0.79, 0.82 and 0.72, with the highest specificity and sensitivity respectively of 88% and 68% for FMDC (threshold at 20%) for predicting RV dysfunction. FMDC had an excellent negative predictive value of 93%.
  
  
  CONCLUSIONS
  RV fractional diameter changes, especially at the mid-level, appear to be accurate for semi-quantitative assessment of RV function by CMR. A cut-off of 20% for FMDC differentiates patients with a low (EF≤40%) or a preserved RVEF.
authors.affiliation: Department of Radiology, University François Rabelais, Tours, France. Electronic address: emmanuellevermes@hotmail.com.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Vermes
authors.affiliation: Department of Radiology, University François Rabelais, Tours, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rebotier
authors.affiliation: Department of Radiology, University François Rabelais, Tours, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Piquemal
authors.affiliation: Department of Radiology, University François Rabelais, Tours, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Pucheux
authors.affiliation: Department of Radiology, University François Rabelais, Tours, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Delhommais
authors.affiliation: Department of Radiology, University François Rabelais, Tours, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Alison
authors.affiliation: Department of Radiology, University François Rabelais, Tours, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Genée
mesh_terms: D000465:Algorithms; D015331:Cohort Studies; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis*
keywords: Cardiac magnetic resonance; Right ventricular ejection fraction; Semi-quantitative assessment; Transversal systolic function