Clinical Research in Cardiology

, Volume 102, Issue 3, pp 229–235 | Cite as

Non-invasive quantification of right ventricular systolic function by echocardiography: a new semi-automated approach

  • Sebastian GreinerEmail author
  • Florian André
  • Melissa Heimisch
  • Alexander Heß
  • Henning Steen
  • Hugo A. Katus
  • Derliz Mereles
Original Paper



Right ventricular (RV) function determines long-term outcome in many cardiopulmonary diseases. However, the assessment of RV function is time-consuming and surrogate parameters derived from two-dimensional (2D) or Doppler echocardiography show poor consistency.


Forty consecutive patients were examined within 30 min after magnetic resonance imaging (MRI) with comprehensive echocardiography, including strain imaging and real-time three-dimensional echocardiography. A new parameter, the RV automated systolic index (RV-ASI), was obtained from the apical four-chamber view using semi-automated border detection.


RV-ASI could be assessed by 2D echocardiography in 38 of 40 patients. RV ejection fraction assessed by MRI was 48 ± 9 %, while RV-ASI was 52 ± 11 % (r = 0.74, SEE = 6 %, p < 0.0001). Intra- and inter-observer variabilities were 7.5 and 8.9 %, respectively. An RV-ASI cut-off value of 52 % in this cohort was able to differentiate between normal and impaired RV function (AUC 0.92, sensitivity 87 %, specificity 93 %).


In this study, the RV-ASI showed to be an easy, rapid to assess and reliable tool for quantification of right ventricular function. Furthermore, this index can complement the assessment of right ventricular mechanics by 2D strain imaging for efficient and comprehensive non-invasive evaluation of right ventricular function.


Right ventricular function Real-time three dimensional echocardiography Strain imaging Magnetic resonance imaging 


Conflict of interest

All authors declare that they have no conflict of interest.

Supplementary material

392_2012_528_MOESM1_ESM.avi (19.1 mb)
Movie 1. Assessment of the right ventricular automated systolic index (RV-ASI) by semi-automated endocardial border detection tool. Two-points are set at the basal segments and one at the apex of the right ventricle. The software conducts automatically the endocardial border detection and calculates the index. Supplementary material 1 (AVI 19594 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Sebastian Greiner
    • 1
    Email author
  • Florian André
    • 1
  • Melissa Heimisch
    • 1
  • Alexander Heß
    • 1
  • Henning Steen
    • 1
  • Hugo A. Katus
    • 1
  • Derliz Mereles
    • 1
  1. 1.Department of Cardiology, Angiology and PneumologyUniversity of HeidelbergHeidelbergGermany

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