Article

Reference values for right ventricular volumes and ejection fraction with real-time three-dimensional echocardiography: evaluation in a large series of normal subjects.

Centro Cardiologico Monzino, IRCCS, Department of Cardiovascular Sciences, University of Milan, Milan, Italy.
Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography (Impact Factor: 2.98). 02/2010; 23(2):109-15. DOI: 10.1016/j.echo.2009.11.026
Source: PubMed

ABSTRACT The quantification of right ventricular (RV) size and function is of diagnostic and prognostic importance. Recently, new software for the analysis of RV geometry using three-dimensional (3D) echocardiographic images has been validated. The aim of this study was to provide normal reference values for RV volumes and function using this technique.
A total of 245 subjects, including 15 to 20 subjects for each gender and age decile, were studied. Dedicated 3D acquisitions of the right ventricle were obtained in all subjects.
The mean RV end-diastolic and end-systolic volumes were 49 +/- 10 and 16 +/- 6 mL/m2 respectively, and the mean RV ejection fraction was 67 +/- 8%. Significant correlations were observed between RV parameters and body surface area. Normalized RV volumes were significantly correlated with age and gender. RV ejection fractions were lower in men, but differences across age deciles were not evident.
The current study provides normal reference values for RV volumes and function that may be useful for the identification of clinical abnormalities.

1 Bookmark
 · 
106 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives The “one-and-a-half ventricle repair” (1.5 VR) is applied to several congenital heart diseases with hypoplastic right ventricle (RV), with good functional and clinical results in infants and children, but feasibility in adult population is being explored.Materials and Methods This is a retrospective analysis of medical records of all adult patients undergoing 1 + 1/5 VR between 2000 and 2012.ResultsFive patients (M/F = 4/1, mean age of 42.3 years, range 29–66.8) underwent 1 + 1/5 VR. Underlying diagnoses were Ebstein's anomaly (EA) in three, hypoplastic RV and tricuspid valve (TV) in two. Mean TV annulus Z-score was −3.0; mean pulmonary vascular resistance was 1.6 WU/m2. Eleven associated procedures were performed simultaneously to 1.5 VR. There were no operative deaths. All patients were discharged home alive and in good clinical condition on anticoagulation regimen. At a mean follow-up of 8.6 ± 5.2 years, there was one cerebral stroke-related death; two patients experienced major complications. Two patients are in NYHA Class I, one is in NYHA Class II, and the last in NYHA Class III on a transplant list.Conclusions The one-and-a-half ventricle repair in adult patients is feasible with low mortality. However, advanced age-associated co-morbidities and prolonged chronic RV preoperative dysfunction may jeopardize long-term results when compared to children.
    Journal of Cardiac Surgery 05/2014; · 1.35 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The cardiac chamber volumes and functions can be assessed manually and automatically using the current computed tomography (CT) workstation system. We aimed to evaluate the accuracy and precision and to establish the reference values for both segmentation methods using cardiac CT angiography (CTA). A total of 134 subjects (mean age 55.3 years, 72 women) without heart disease were enrolled in the study. The cardiac four-chamber volumes, left ventricular (LV) mass, and biventricular functions were measured with manual, semiautomatic, and model-based fully automatic approaches. The accuracies of the semiautomated and fully automated approaches were validated by comparing them with manual segmentation as a reference. The precision error was determined and compared for both manual and automatic measurements. No significant difference was found between the manual and semiautomatic assessments for the assessment of all functional parameters (P > .05). Using the manual method as a reference, the automatic approach provided a similar value in LV ejection fraction and left atrial volumes in both genders and right ventricular (RV) stroke volume in women (P > .05), with some underestimation of RV volume (P < .001) and overestimation of all remaining parameters (P < .05) in both genders. In addition, a significantly higher precision with a considerable association in intermeasurement (reproducibility) was observed using the automated approach. The model-based fully automatic segmentation algorithm can help with the assessment of the cardiac four-chamber volume and function. This may help in establishing reference values of functional parameters in patients who undergo cardiac CTA.
    Academic radiology 05/2014; 21(5):639-47. · 2.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The study of the right ventricular (RV) chamber has been recently improved by use of the 3D method. In young asymptomatic trained athletes, RV is not routinely investigated if not in suspected disease. This study is designed to test if the 3D method compared to 2D, adds information to study of RV morphology and function, in the early stages of myocardial remodeling of a group of young athletes. The RV chamber function was assessed in 25 young trained athletes (20 soccer and 5 basketball) aged 20±3 yrs and compared to 20 sedentary controls by 2D-AC and 3D-RV methods (TomTec), measuring RV diastolic (RVDV) and systolic (RVSV) volumes or ejection fraction (EF). 3D RV volumes were slightly higher in athletes than the 2D volumes in presence of lower EF values, but not significantly higher than in sedentary. Significant differences were conversely found comparing 3D systolic and diastolic RV volumes and 2D-AC volumes within each group with higher values in athletes (RVDV: P=0.001 for athletes and P<0.001 for sedentary, and RVSV: P<0.04 for athletes and P<0.001 for sedentary). Although the found EF values were substantially similar, the morphological assessment of the initial modifications of this chamber of the young "athlete's heart", results seem to be more accurate using the 3D method than 2D. The clinical implication of this aspect could be of interest in case of difficulty in drawing a clear diagnosis of any RV chamber disease in young athletes.
    Asian journal of sports medicine. 12/2013; 4(4):281-8.