title: A Novel 13-Segment Standardized Model for Assessment of Right Ventricular Function Using Two-Dimensional iRotate Echocardiography.
abstract: OBJECTIVE
  The aim of this study was to evaluate the feasibility of transthoracic two-dimensional (2D) iRotate, a new echo modality, to assess the whole right ventricle (RV) from a single transducer position based on anatomic landmarks.
  
  
  RESULTS
  The anatomic landmarks were first defined based on three-dimensional echocardiographic datasets using multiplane reconstruction analyses. Thereafter, we included 120 healthy subjects (51% male, age range 21-67 years). Using 2D iRotate, four views of the RV could be acquired based on these landmarks. The anterior, lateral, inferior wall (divided into three segments: basal-mid-apical), and right ventricular outflow tract (RVOT) anterior wall of the RV were determined. The feasibility of visualization of RV segments and tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler imaging (TDI) measurements were assessed. To evaluate this model for diseased RVs, a small pilot study of 20 patients was performed. In 98% of healthy subjects and 100% of patients, iRotate mode was feasible to assess the RV from one single transducer position. In total, 86% and 95%, respectively, of the RV segments could be visualized. The visualization of the RVOT anterior wall was worse 23% and 75%, respectively. TAPSE and TDI measurements on all four views were feasible 93% and 92%, respectively, of the healthy subjects and in 100% of the patients.
  
  
  CONCLUSIONS
  With 2D iRotate, a comprehensive evaluation of the entire normal and diseased RV is feasible from a fixed transducer position based on anatomic landmarks. This is less time-consuming than the multiview approach and enhances accuracy of RV evaluation. Imaging of the RVOT segment remains challenging.
authors.affiliation: Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Jackie S
authors.initials: JS
authors.lastname: McGhie
authors.affiliation: Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Myrthe E
authors.initials: ME
authors.lastname: Menting
authors.affiliation: Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Wim B
authors.initials: WB
authors.lastname: Vletter
authors.affiliation: Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: René
authors.initials: R
authors.lastname: Frowijn
authors.affiliation: Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Jolien W
authors.initials: JW
authors.lastname: Roos-Hesselink
authors.affiliation: Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Osama I I
authors.initials: OI
authors.lastname: Soliman
authors.affiliation: Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Heleen B
authors.initials: HB
authors.lastname: van der Zwaan
authors.affiliation: Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Marcel L
authors.initials: ML
authors.lastname: Geleijnse
authors.affiliation: Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Annemien E
authors.initials: AE
authors.lastname: van den Bosch
mesh_terms: D000328:Adult; D000368:Aged; D059925:Anatomic Landmarks / Q000000981:diagnostic imaging*; D003198:Computer Simulation; D004452:Echocardiography / Q000379:methods* / Q000592:standards*; D005240:Feasibility Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods / Q000592:standards; D007090:Image Interpretation, Computer-Assisted / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D009426:Netherlands; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: anatomic landmarks; right ventricular; single transducer position; two-dimensional iRotate mode