Echocardiographic measurements of the right ventricle: right ventricular outflow tract 1.
ABSTRACT The size of the ventricles of the heart is important to establish during the clinical echocardiographic examination. Due to the complex anatomy of the right ventricle, it is difficult to measure its size at times. One of the most frequently used ways is to measure the right ventricular outflow tract (RVOT1), probably due to its good reproducibility. However, in the literature different ways are described to measure RVOT1, both at different sites and using different methods such as M-mode and 2D. The first aim of the present study was to exam if there is a significant difference in the outcome of RVOT1 using different sites and methods to measure it. The second aim was to study if there is a significant difference between the usually preferred left lateral decubitus position during the echocardiographic examination and the supine decubitus position, which the echocardiographer sometimes can be compelled to use if the patient is unable to lie in the left lateral decubitus position.
Twenty-seven healthy subjects were included and examined by echocardiography. RVOT1 was measured at different sites using different methods; first with the subject in the left lateral decubitus position and then repeating the same measurements with the subject in the supine decubitus position.
Comparing the RVOT1 measured at different sites and with different methods showed an overall significant difference (p < 0.001). Also when comparing the different body positions, there was an overall significant difference (p = 0.001).
When comparing RVOT1 of the same patient or subject over time, the results from the present study indicate that the same site, method and body position should be used.
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ABSTRACT: ABSTARCT: BACKGROUND: Environmental stresses, such as immersion, cold, and venous gas microbubbles, have been shown to contribute to an increase in pulmonary artery pressure (PAP) after single SCUBA dives. This study was carried out to investigate PAP changes following a dry chamber dive. METHODS: 17 male divers [mean age 32 years, standard deviation (SD) 7 years, mean body mass index 26 kg m(-2) (SD 3 kg m(-2))] participated in the study. Heart disease was ruled out by ECG, stress-ECG and transthoracic echocardiography in all subjects. Echocardiographic assessment of PAP (peak gradient at pulmonary and tricuspid valve), acceleration time (AT), ejection time (ET) and the ratio AT/ET as an estimate of PAP was performed directly prior to, directly, and 20 and 80 min after a simulated dive (maximal pressure 600 kPa, duration 60 min). RESULTS: AT/ET decreased from 0.40 (SD 0.03) to 0.34 (SD 0.03) directly after the dive (p = <0.0001), which was statistically significant, whereas 80 min after decompression, AT/ET tended to return to baseline levels (0.36, SD 0.03; p = 0.001). Other echocardiographic indices, e.g. ET, systolic PAP, and heart rate, did not change significantly after the dive. No gas microbubbles were detected during or after decompression. CONCLUSIONS: A transient decrease of both AT and AT/ET following a simulated hyperbaric dry chamber dive indicated an increase in mean PAP in healthy men. We speculate that factors other than immersion, cold, or gas microbubbles may contribute to an elevation of PAP after a single hyperbaric exposure.Clinical Research in Cardiology 06/2012; · 3.67 Impact Factor
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ABSTRACT: It is clinically important to evaluate the severity of right ventricular (RV) overload in patients with chronic obstructive pulmonary disease (COPD), which is often associated with changes in the structure and the function of the right ventricle. Noninvasive and reliable assessment of RV function would be an essential determinant of RV load and a clinically useful factor for assessing cardiovascular risk in COPD patients. The aim of this study was to investigate the clinical application value of right ventricular outflow tract (RVOT) systolic function measured by transthoracic echocardiography in patients with COPD. We prospectively investigated COPD male patients and compared them with healthy controls. In addition to RV conventional echocardiographic parameters, RVOT size and fractional shortening (RVOT-FS) parameters were also assessed. Fifty-five COPD patients (all men; mean age, 62 ± 9 years) participated in the study, and were compared with a control group consisting of 21male, healthy, nonsmoking subjects with a mean age of 58 ± 11 years. The RVOT-FS was impaired in COPD patients than healthy controls (27.8 ± 15.5 vs. 57.5 ± 8.6, p < 0.001), and was correlated positively with tricuspid annular plane systolic excursion (TAPSE; r = 0.583, p < 0.001) and pulmonary acceleration time (r = 0.666, p < 0.001) and inversely with pulmonary artery systolic pressure (r = 0.605, p < 0.001) and functional capacity(r = - 0.589, p < 0.001). There was a statistically significant difference in RVOT-FS among the COPD subgroups with regard to New York Heart Association functional classification (p < 0.001). The RVOT-FS is a noninvasive easily applicable measure of RV systolic function and is well correlated with functional capacity in COPD patients. Its combination with long-axis measurements via TAPSE and transtricuspid Doppler analysis may provide a comprehensive evaluation of the RV performance in COPD patients.Herz 11/2013; · 0.78 Impact Factor