title: 2D Echocardiographic Evaluation of Right Ventricular Function Correlates With 3D Volumetric Models in Cardiac Surgery Patients.
abstract: OBJECTIVE
  The early diagnosis and treatment of right ventricular (RV) dysfunction are of critical importance in cardiac surgery patients and impact clinical outcome. Two-dimensional (2D) transesophageal echocardiography (TEE) can be used to evaluate RV function using surrogate parameters due to complex RV geometry. The aim of this study was to evaluate whether the commonly used visual evaluation of RV function and size using 2D TEE correlated with the calculated three-dimensional (3D) volumetric models of RV function.
  
  
  METHODS
  Retrospective study, single center, University Hospital.
  
  
  METHODS
  Seventy complete datasets were studied consisting of 2D 4-chamber view loops (2-3 beats) and the corresponding 4-chamber view 3D full-volume loop of the right ventricle. RV function and RV size of the 2D loops then were assessed retrospectively purely qualitatively individually by 4 clinician echocardiographers certified in perioperative TEE. Corresponding 3D volumetric models calculating RV ejection fraction and RV end-diastolic volumes then were established and compared with the 2D assessments.
  
  
  RESULTS
  2D assessment of RV function correlated with 3D volumetric calculations (Spearman's rho -0.5; p<0.0001). No correlation could be established between 2D estimates of RV size and actual 3D volumetric end-diastolic volumes (Spearman's rho 0.15; p = 0.25).
  
  
  CONCLUSIONS
  The 2D assessment of right ventricular function based on visual estimation as frequently used in clinical practice appeared to be a reliable method of RV functional evaluation. However, 2D assessment of RV size seemed unreliable and should be used with caution.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany.
authors.forename: Harry
authors.initials: H
authors.lastname: Magunia
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany.
authors.forename: Eckhard
authors.initials: E
authors.lastname: Schmid
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany; Department of Anesthesiology and Intensive Care Medicine, Herzentrum Lahr, Lahr, Germany.
authors.forename: Jan N
authors.initials: JN
authors.lastname: Hilberath
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany.
authors.forename: Leo
authors.initials: L
authors.lastname: Häberle
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Grasshoff
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schlensak
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Rosenberger
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany. Electronic address: martina.nowak-machen@med.uni-tuebingen.de.
authors.forename: Martina
authors.initials: M
authors.lastname: Nowak-Machen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000592:standards*; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods / Q000592:standards; D019560:Echocardiography, Three-Dimensional / Q000379:methods / Q000592:standards*; D017548:Echocardiography, Transesophageal / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult
keywords: 2-dimensional TEE; 3-dimensional TEE; ejection fraction; right ventricle