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: 4.06). 02/2010; 23(2):109-15. DOI: 10.1016/j.echo.2009.11.026
Source: PubMed


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.

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    • "Papillary muscles, moderator bands and trabeculae were included in the RV cavity volume as literature reports [10, 11]. The software applies a 3D surface with specific RV proprieties, resulting an initial 3D RV Beutel [10, 11] that is stored as a triangulated surface. Finally, an automatic contour finding algorithm was applied, using the initial RV Beutel surface as a guide. "
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    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.
    Full-text · Article · Dec 2013 · Asian Journal of Sports Medicine
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    • "Compared to these normal values, our subjects had larger ventricles; this is most likely due to the fact that we have examined well trained athletes [17]. The RVEF in our subjects is lower than the published normal values [16]. Still, it is in normal range in all subjects before and after endurance exercise. "
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    ABSTRACT: Our study compares new single beat 3D echocardiography (sb3DE) to cardiovascular magnetic resonance imaging (CMR) for the measurement of right ventricular (RV) dimension and function immediately after a 30 km run. This is to validate sb3DE against the "gold standard" CMR and to bring new insights into acute changes of RV dimension and function after endurance exercise. 21 non-elite male marathon runners were examined by sb3DE (Siemens ACUSON SC2000, matrix transducer 4Z1c, volume rates 10-29/s), CMR (Siemens Magnetom Avanto, 1,5 Tesla) and blood tests before and immediately after each athlete ran 30 km. The runners were not allowed to rehydrate after the race. The order of sb3DE and CMR examination was randomized. Sb3DE for the acquisition of RV dimension and function was feasible in all subjects. The decrease in mean body weight and the significant increase in hematocrit indicated dehydration. RV dimensions measured by CMR were consistently larger than measured by sb3DE.Neither sb3DE nor CMR showed a significant difference in the RV ejection fraction before and after exercise. CMR demonstrated a significant decrease in RV dimensions. Measured by sb3DE, this decrease of RV volumes was not significant. First, both methods agree well in the acquisition of systolic RV function. The dimensions of the RV measured by CMR are larger than measured by sb3DE. After exercise, the RV volumes decrease significantly when measured by CMR compared to baseline.Second, endurance exercise seems not to induce acute RV dysfunction in athletes without rehydration.
    Full-text · Article · Feb 2012 · Cardiovascular Ultrasound
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    • "The systo-diastolic RV shape highlights the unhomogeneous RV contractility related to the degree of its dysfunction. RV volumes and RVEF% evaluated with 3-DE were significantly increased (volumes) and decreased (ejection fraction) respectively, in comparison to the normals,8) and are well correlated with MRI estimated as reference method.9) 3DE slightly overestimated RV end diastolic and end systolic volumes, although the degree of overestimation was not significant. "
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    ABSTRACT: Carcinoid heart disease is a rare cause of heart failure with or without right valvular heart impairments. In this study, we showed a case of carcinoid tumour with hepatic metastases inducing carcinoid heart disease. Neuroendocrine heart involvement happens for severe tricuspid valve insufficiency and plaques on right ventricular (RV) walls produced by a release of serotonin (5-HT). A patient affected by primitive ileal tumour with 5-HT-secernent hepatic metastases inducing tricuspid insufficiency is showed. Transthoracic 2-D echocardiography showed tricuspid valve regurgitation and both right atrium, RV-walls plaques and RV dilation. Continue-wave Doppler showed a characteristic "dagger shaped" spectrum of tricuspid systolic flow. RV function was evaluated with 3-D transthoracic echocardiography. In particular, RV volumes, RV ejection fraction and stroke volume were defined by this technique. 2, 3-D echocardiography and Doppler method are useful techniques to show heart valves' derangements and RV function to non-invasively detect RV impairments in carcinoid heart disease.
    Full-text · Article · Jun 2011 · Journal of cardiovascular ultrasound
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