title: Echocardiographic linear fractional shortening for quantification of right ventricular systolic function-A cardiac magnetic resonance validation study.
abstract: BACKGROUND
  Echocardiography (echo)-based linear fractional shortening (FS) is widely used to assess left ventricular dysfunction (LVdys), but has not been systematically tested for right ventricular dysfunction (RVdys).
  
  
  METHODS
  The population comprised LVdyspatients with and without RVdys(EF<50%) on cardiac MRI (CMR): Echo included standard RV indices (fractional area change [FAC], TAPSE, S', and FS in parasternal long-axis (RV outflow tract [RVOT]) and apical four-chamber views (width [RVWD], length [RVLG]).
  
  
  RESULTS
  A total of 168 patients underwent echo and CMR (3±3 days); FAC (46±9 vs 28±11), TAPSE (1.9±0.4 vs 1.5±0.3), and S' (11.4±2.3 vs 10.0±2.6, all P≤.001) were lower among RVdyspatients, as were FS indices (RVOT32±8 vs 17±10 | RVWD40±11 vs 22±12 | RVLG16±5 vs 9±4%; all P<.001). FS indices yielded similar magnitude of correlation with CMR RVEF (r=.73-.56) as did FAC (r=.70), which was slightly higher than TAPSE (r=.47) and S' (r=.31; all P<.001). FS indices decreased stepwise vs CMR RVEF tertiles, as did FAC (all P<.001). In multivariate analysis, FS in RVOT(regression coefficient .51 [CI 0.37-0.65]), RVWD(0.30 [0.19-0.41]), and RVLG(0.45 [0.20-0.71]; all P≤.001) was independently associated with CMR RVEF. FS indices yielded good overall diagnostic performance (AUC: RVOT0.89 [CI 0.82-0.97] | RVWD0.87 [0.78-0.96] | RVLG0.80 [0.70-0.90]; all P<.001) for CMR-defined RVdy(RVEF<50%).
  
  
  CONCLUSIONS
  RV linear FS provides RV functional indices that parallel CMR RVEF. Parasternal long-axis RVOTwidth, four-chamber RV width, and length are independently associated with RVEF, supporting use of multiple FS indices for RV functional assessment.
authors.affiliation: Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Aparna
authors.initials: A
authors.lastname: Srinivasan
authors.affiliation: Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.|Department of Radiology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Jiwon
authors.initials: J
authors.lastname: Kim
authors.affiliation: Cardiology Division, Department of Medicine, Columbia University, New York, NY, USA.
authors.forename: Omar
authors.initials: O
authors.lastname: Khalique
authors.affiliation: Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Alexi
authors.initials: A
authors.lastname: Geevarghese
authors.affiliation: Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Rusli
authors.affiliation: Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Tara
authors.initials: T
authors.lastname: Shah
authors.affiliation: Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Antonino
authors.initials: A
authors.lastname: Di Franco
authors.affiliation: Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Javid
authors.initials: J
authors.lastname: Alakbarli
authors.affiliation: Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Goldburg
authors.affiliation: Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Rozenstrauch
authors.affiliation: Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
authors.affiliation: Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.|Department of Radiology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Weinsaft
mesh_terms: D004452:Echocardiography / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D013599:Systole; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology*
keywords: cardiovascular magnetic resonance; echocardiography; right ventricle