Skip to main content
SpringerLink
Log in

Multi-parametric “on board” evaluation of right ventricular function using three-dimensional echocardiography: feasibility and comparison to traditional two-and three dimensional echocardiographic measurements

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Three-dimensional echocardiographic (3DE) of right ventricle (RV) has been validated in many clinical settings. However, the necessity of complicated and off–line dedicated software has reduced its diffusion. A new simplified “on board” 3DE software (OB) has been developed to obtain RV volumes and ejection fraction (EF) together with several conventional parameters automatically derived from 3DE: tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), longitudinal strain (LS). Aims of this study were to evaluate feasibility and accuracy of OB RV analysis. A complete 2DE and 3DE with OB 3DRV evaluation was obtained in 35 normal subjects and 105 patients with different pathologies. Results were compared with the conventional off-line software (OFL) and with the 2D-derived corresponding values. A subgroup of 22 patients underwent also cardiac CMR. OB 3DRV was feasible in 133/140 cases (95%) in a mean time of 97.5 ± 33 s lower than OFL analysis (129 ± 52 s plus dataset loading 80 ± 24 s). Imaging quality was good in 84%. OB and OFL 3DE RV volumes and EF were similar. 3DE derived FSA and LS (but not TAPSE) were similar to 2DE values and correlated with tissue Doppler systolic peak velocity, dP/dt, systolic pulmonary pressure and myocardial performance index. OB RV volumes and EF well correlated with CMR. (bias + SD: − 21.5 ± 20 mL for EDV; − 8.2 ± 12.4 mL for ESV; − 1 ± 5.9% for EF). OB 3DE method is feasible, simple, time saving. It easily provides 3DE RV volumes and multiple functional parameters. Off-line operator border adjustment may improve accuracy of 3DE TAPSE.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Pruszczyk P, Goliszek S, Lichodziejewska B, Kostrubiec M, Ciurzyński M, Kurnicka K, Dzikowska-Diduch O, Palczewski P, Wyzgal A (2014) Prognostic value of echocardiography in normotensive patients with acute pulmonary embolism. JACC Cardiovasc Imaging 7:553–560. https://doi.org/10.1016/j.jcmg.2013.11.004

    Article  PubMed  Google Scholar 

  2. Saguner AM, Vecchiati A, Baldinger SH et al (2014) Different prognostic value of functional right ventricular parameters in arrhythmogenic right ventricular cardiomyopathy/dysplasia. Circ Cardiovasc Imaging 7(2):230–239. https://doi.org/10.1161/CIRCIMAGING.113.000210

    Article  PubMed  Google Scholar 

  3. Sabe MA, Sabe SA, Kusunose K, Flamm SD, Griffin BP, Kwon DH (2016) Predictors and prognostic significance of right ventricular ejection fraction in patients with ischemic cardiomyopathy. Circulation 134(9):656–665. https://doi.org/10.1161/CIRCULATIONAHA.116.022339

    Article  PubMed  Google Scholar 

  4. Nagata Y, Wu VC, Kado Y, Otani K, Lin FC, Otsuji Y, Negishi K, Takeuchi M (2017) Prognostic value of right ventricular ejection fraction assessed by transthoracic 3D echocardiography. Circ Cardiovasc Imaging 10:e005384. https://doi.org/10.1161/CIRCIMAGING.116.005384

    Article  PubMed  Google Scholar 

  5. Niemann PS, Pinho L, Balbach T, Galuschky C, Blankenhagen M, Silberbach M, Broberg C, Jerosch-Herold M, Sahn DJ (2007) Anatomically oriented right ventricular volume measurements with dynamic three-dimensional echocardiography validated by 3-Tesla magnetic resonance imaging. J Am Coll Cardiol 50(17):1668–1676. https://doi.org/10.1016/j.jacc.2007.07.031

    Article  PubMed  Google Scholar 

  6. Tamborini G, Brusoni D, Torres Molina JE, Galli CA, Maltagliati A, Muratori M, Susini F, Colombo C, Maffessanti F, Pepi M (2008) Feasibility of a new generation three-dimensional echocardiography for right ventricular volumetric and functional measurements. Am J Cardiol 102(4):499–505. https://doi.org/10.1016/j.amjcard.2008.03.084

    Article  PubMed  Google Scholar 

  7. Fusini L, Tamborini G, Gripari P, Maffessanti F, Mazzanti V, Muratori M, Salvi L, Sisillo E, Caiani EG, Alamanni F, Fiorentini C, Pepi M (2011) Feasibility of intraoperative three-dimensional transesophageal echocardiography in the evaluation of right ventricular volumes and function in patients undergoing cardiac surgery. J Am Soc Echocardiogr 24(8):868–877. https://doi.org/10.1016/j.echo.2011.05.002

    Article  PubMed  Google Scholar 

  8. Sugeng L, Mor-Avi V, Weinert L, Niel J, Ebner C, Steringer-Mascherbauer R, Bartolles R, Baumann R, Schummers G, Lang RM, Nesser HJ (2010) Multimodality comparison of quantitative volumetric analysis of the right ventricle. JACC Cardiovasc Imaging 3(1):10–18. https://doi.org/10.1016/j.jcmg.2009.09.017

    Article  PubMed  Google Scholar 

  9. Shimada YJ1, Shiota M, Siegel RJ, Shiota T (2010) Accuracy of right ventricular volumes and function determined by three-dimensional echocardiography in comparison with magnetic resonance imaging: a meta-analysis study. J Am Soc Echocardiogr 23(9):943–953

    Article  PubMed  Google Scholar 

  10. Lang RM, Badano LP, Mor-Avi V et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J 28(1):1–39.e14. https://doi.org/10.1016/j.echo.2014.10.003

    Article  Google Scholar 

  11. Tamborini G, Marsan NA, Gripari P, Maffessanti F, Brusoni D, Muratori M, Caiani EG, Fiorentini C, Pepi M (2010) Reference values for right ventricular volumes and ejection fraction with real-time three-dimensional echocardiography: evaluation in a large series of normal subjects. J Am Soc Echocardiogr 23(2):109–115. https://doi.org/10.1016/j.echo.2009.11.026

    Article  PubMed  Google Scholar 

  12. Maffessanti F, Muraru D, Esposito R, Gripari P, Ermacora D, Santoro C, Tamborini G, Galderisi M, Pepi M, Badano LP (2013) Age-, body size-, and sex-specific reference values for right ventricular volumes and ejection fraction by three-dimensional echocardiography: a multicenter echocardiographic study in 507 healthy volunteers. Circ Cardiovasc Imaging 6(5):700–710. https://doi.org/10.1161/CIRCIMAGING.113.000706

    Article  PubMed  Google Scholar 

  13. Tamborini G, Muratori M, Brusoni D, Celeste F, Maffessanti F, Caiani EG, Alamanni F, Pepi M (2009) Is right ventricular systolic function reduced after cardiac surgery? A two- and three-dimensional echocardiographic study. Eur J Echocardiogr 10(5):630–634. https://doi.org/10.1093/ejechocard/jep015

    Article  PubMed  Google Scholar 

  14. Prakasa KR1, Dalal D, Wang J et al (2006) Feasibility and variability of three dimensional echocardiography in arrhythmogenic right ventricular dysplasia/cardiomyopathy. Am J Cardiol 97(5):703–709

    Article  PubMed  Google Scholar 

  15. Leibundgut G, Rohner A, Grize L, Bernheim A, Kessel-Schaefer A, Bremerich J, Zellweger M, Buser P, Handke M (2010) Dynamic assessment of right ventricular volumes and function by real-time three-dimensional echocardiography: a comparison study with magnetic resonance imaging in 100 adult patients. J Am Soc Echocardiogr 23(2):116–126. https://doi.org/10.1016/j.echo.2009.11.016

    Article  PubMed  Google Scholar 

  16. Rudski LG1, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23(7):685–713. https://doi.org/10.1016/j.echo.2010.05.010

    Article  Google Scholar 

  17. La Gerche A, Jurcut R, Voigt JU (2010) Right ventricular function by strain echocardiography. Curr Opin Cardiol 25(5):430–436. https://doi.org/10.1097/HCO.0b013e32833b5f94

    Article  PubMed  Google Scholar 

  18. Ryo K, Goda A, Onishi T, Delgado-Montero A, Tayal B, Champion HC, Simon MA, Mathier MA, Gladwin MT, Gorcsan J 3rd (2015) Characterization of right ventricular remodeling in pulmonary hypertension associated with patient outcomes by 3-dimensional wall motion tracking echocardiography. Circ Cardiovasc Imaging 8(6):e003176. https://doi.org/10.1161/CIRCIMAGING.114.003176

    Article  PubMed  Google Scholar 

  19. Miller D, Farah MG, Liner A, Fox K, Schluchter M, Hoit BD (2004) The relation between quantitative right ventricular ejection fraction and indices of tricuspid annular motion and myocardial performance. J Am Soc Echocardiogr 17: 443–447. https://doi.org/10.1016/j.echo.2004.01.010

    Article  PubMed  Google Scholar 

  20. Medvedofsky D, Addetia K, Patel AR, Sedlmeier A, Baumann R, Mor-Avi V, Lang RM (2015) Novel approach to three-dimensional echocardiographic quantification of right ventricular volumes and function from focused views. J Am Soc Echocardiogr 28(10):1222–1231. https://doi.org/10.1016/j.echo.2015.06.013

    Article  PubMed  Google Scholar 

  21. Muraru D, Spadotto V, Cecchetto A, Romeo G, Aruta P, Ermacora D, Jenei C, Cucchini U, Iliceto S, Badano LP (2016) New speckle-tracking algorithm for right ventricular volume analysis from three-dimensional echocardiographic data sets: validation with cardiac magnetic resonance and comparison with the previous analysis tool. Eur Heart J Cardiovasc Imaging 17(11):1279–1289. https://doi.org/10.1093/ehjci/jev309

    Article  PubMed  Google Scholar 

  22. Mor-Avi V, Lang RM, Badano LP et al (2011) Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. J Am Soc Echocardiogr 24(3):277–313. https://doi.org/10.1016/j.echo.2011.01.015

    Article  Google Scholar 

  23. Cameli M, Lisi M, Righini FM, Focardi M, Lunghetti S, Bernazzali S, Marchetti L, Biagioli B, Galderisi M, Maccherini M, Sani G, Mondillo S (2013) Speckle tracking echocardiography as a new technique to evaluate right ventricular function in patients with left ventricular assist device therapy. J Heart Lung Transplant 32(4):424–430. https://doi.org/10.1016/j.healun.2012.12.010

    Article  PubMed  Google Scholar 

  24. Morris DA, Krisper M, Nakatani S et al (2017) Normal range and usefulness of right ventricular systolic strain to detect subtle right ventricular systolic abnormalities in patients with heart failure: a multicentre study. Eur Heart J Cardiovasc Imaging 18(2):212–223. https://doi.org/10.1093/ehjci/jew011

    Article  PubMed  Google Scholar 

  25. Muraru D, Cucchini U, Mihăilă S, Miglioranza MH, Aruta P, Cavalli G, Cecchetto A, Padayattil-Josè S, Peluso D, Iliceto S, Badano LP (2014) Left ventricular myocardial strain by three-dimensional speckle-tracking echocardiography in healthy subjects: reference values and analysis of their physiologic and technical determinants. J Am Soc Echocardiogr 27(8):858–871.e1. https://doi.org/10.1016/j.echo.2014.05.010

    Article  PubMed  Google Scholar 

  26. Tamborini G, Pepi M, Galli CA, Maltagliati A, Celeste F, Muratori M, Rezvanieh S, Veglia F (2007) Feasibility and accuracy of a routine echocardiographic assessment of right ventricular function. Int J Cardiol 31(1):86–89. https://doi.org/10.1016/j.ijcard.2006.01.017115

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Centro Cardiologico Monzino IRCCS, Via Parea 4, 20138, Milan, Italy

    Gloria Tamborini, Claudia Cefalù, Fabrizio Celeste, Laura Fusini, Anna Garlaschè, Manuela Muratori, Sarah Ghulam Ali, Paola Gripari, Giovanni Berna & Mauro Pepi

Authors
  1. Gloria Tamborini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Claudia Cefalù
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fabrizio Celeste
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Laura Fusini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anna Garlaschè
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Manuela Muratori
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sarah Ghulam Ali
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Paola Gripari
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Giovanni Berna
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Mauro Pepi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gloria Tamborini.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Research involving human participants

This article does not contain any studies with animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tamborini, G., Cefalù, C., Celeste, F. et al. Multi-parametric “on board” evaluation of right ventricular function using three-dimensional echocardiography: feasibility and comparison to traditional two-and three dimensional echocardiographic measurements. Int J Cardiovasc Imaging 35, 275–284 (2019). https://doi.org/10.1007/s10554-018-1496-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-018-1496-9

Keywords

Search

Navigation