Comparison Between Four-Chamber and Right Ventricular-Focused Views for the Quantitative Evaluation of Right Ventricular Size and Function.


Journal

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
ISSN: 1097-6795
Titre abrégé: J Am Soc Echocardiogr
Pays: United States
ID NLM: 8801388

Informations de publication

Date de publication:
04 2019
Historique:
received: 24 09 2018
pubmed: 29 1 2019
medline: 23 10 2020
entrez: 29 1 2019
Statut: ppublish

Résumé

Right ventricular (RV) function plays a pivotal prognostic role in multiple cardiac diseases. Echocardiography guidelines recommend that RV quantification be performed in the RV-focused view, which is theoretically more reproducible than the four-chamber (4Ch) view. However, differences between views in RV size and function measurements have never been systematically studied. Accordingly, the aim of this study was to compare (1) RV size and function parameters obtained from the RV-focused and 4Ch views and (2) test-retest variability between these two views. Fifty patients (26 men; mean age, 63 ± 18 years) undergoing clinically indicated transthoracic echocardiography were prospectively enrolled. Each patient underwent three repeated acquisitions of the 4Ch and RV-focused views by two sonographers. The first operator performed two acquisitions at the beginning and the end of the clinical transthoracic echocardiographic study, and the second operator performed the third acquisition afterward. RV size and function measurements were obtained from the two views and compared using paired t-test analysis and Bland-Altman analysis. Intra- and interoperator test-retest and intra- and interreader variability for both views were assessed using intraclass correlations and coefficients of variation. All RV size parameters were significantly larger when measured in the RV-focused view compared with the 4Ch view. Also, all RV function parameters, including RV free wall and global longitudinal strain, were larger in magnitude when measured in the RV-focused view. Measurements variability was consistently better for the RV-focused view. RV size and function measurements obtained from the RV-focused and 4Ch views are not interchangeable. RV size and function parameters measured from the RV-focused view are more reproducible than from 4Ch acquisitions. Therefore, only the RV-focused view should be used for quantitative assessment of the right ventricle.

Sections du résumé

BACKGROUND
Right ventricular (RV) function plays a pivotal prognostic role in multiple cardiac diseases. Echocardiography guidelines recommend that RV quantification be performed in the RV-focused view, which is theoretically more reproducible than the four-chamber (4Ch) view. However, differences between views in RV size and function measurements have never been systematically studied. Accordingly, the aim of this study was to compare (1) RV size and function parameters obtained from the RV-focused and 4Ch views and (2) test-retest variability between these two views.
METHODS
Fifty patients (26 men; mean age, 63 ± 18 years) undergoing clinically indicated transthoracic echocardiography were prospectively enrolled. Each patient underwent three repeated acquisitions of the 4Ch and RV-focused views by two sonographers. The first operator performed two acquisitions at the beginning and the end of the clinical transthoracic echocardiographic study, and the second operator performed the third acquisition afterward. RV size and function measurements were obtained from the two views and compared using paired t-test analysis and Bland-Altman analysis. Intra- and interoperator test-retest and intra- and interreader variability for both views were assessed using intraclass correlations and coefficients of variation.
RESULTS
All RV size parameters were significantly larger when measured in the RV-focused view compared with the 4Ch view. Also, all RV function parameters, including RV free wall and global longitudinal strain, were larger in magnitude when measured in the RV-focused view. Measurements variability was consistently better for the RV-focused view.
CONCLUSIONS
RV size and function measurements obtained from the RV-focused and 4Ch views are not interchangeable. RV size and function parameters measured from the RV-focused view are more reproducible than from 4Ch acquisitions. Therefore, only the RV-focused view should be used for quantitative assessment of the right ventricle.

Identifiants

pubmed: 30686498
pii: S0894-7317(18)30677-1
doi: 10.1016/j.echo.2018.11.014
pii:
doi:

Types de publication

Comparative Study Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

484-494

Informations de copyright

Copyright © 2018 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

Auteurs

Davide Genovese (D)

University of Chicago Medical Center, Chicago, Illinois; Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.

Victor Mor-Avi (V)

University of Chicago Medical Center, Chicago, Illinois.

Chiara Palermo (C)

Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.

Denisa Muraru (D)

Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.

Valentina Volpato (V)

University of Chicago Medical Center, Chicago, Illinois; Department of Cardiovascular Sciences, Centro Cardiologico Monzino, Milan, Italy.

Eric Kruse (E)

University of Chicago Medical Center, Chicago, Illinois.

Megan Yamat (M)

University of Chicago Medical Center, Chicago, Illinois.

Patrizia Aruta (P)

Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.

Karima Addetia (K)

University of Chicago Medical Center, Chicago, Illinois.

Luigi P Badano (LP)

Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.

Roberto M Lang (RM)

University of Chicago Medical Center, Chicago, Illinois. Electronic address: rlang@bsd.uchicago.edu.

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Classifications MeSH