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Value of echocardiography using knowledge-based reconstruction in determining right ventricular volumes in pulmonary sarcoidosis: comparison with cardiac magnetic resonance imaging

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Abstract

Right ventricular (RV) dysfunction in sarcoidosis is associated with adverse outcomes. Assessment of RV function by conventional transthoracic echocardiography (TTE) is challenging due to the complex RV geometry. Knowledge-based reconstruction (KBR) combines TTE measurements with three-dimensional coordinates to determine RV volumes. The aim of this study was to investigate the accuracy of TTE-KBR compared to the gold standard cardiac magnetic resonance imaging (CMR) in determining RV dimensions in pulmonary sarcoidosis. Pulmonary sarcoidosis patients prospectively received same-day TTE and TTE-KBR. If performed, CMR within 90 days after TTE-KBR was used as reference standard. Outcome parameters included RV end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (RVSV) and ejection fraction (RVEF). 281 patients underwent same day TTE and TTE-KBR. In total, 122 patients received a CMR within 90 days of TTE and were included. TTE-KBR measured RVEDV and RVESV showed strong correlation with CMR measurements (R = 0.73, R = 0.76), while RVSV and RVEF correlated weakly (R = 0.46, R = 0.46). Bland–Altman analyses (mean bias ± 95% limits of agreement), showed good agreement for RVEDV (ΔRVEDVKBR-CMR, 5.67 ± 55.4 mL), while RVESV, RVSV and RVEF showed poor agreement (ΔRVESVKBR-CMR, 21.6 ± 34.1 mL; ΔRVSVKBR-CMR, − 16.1 ± 42.9 mL; ΔRVEFKBR-CMR, − 12.9 ± 16.4%). The image quality and time between CMR and TTE-KBR showed no impact on intermodality differences and there was no sign of a possible learning curve. TTE-KBR is convenient and shows good agreement with CMR for RVEDV. However, there is poor agreement for RVESV, RVSV and RVEF. The use of TTE-KBR does not seem to provide additional value in the determination of RV dimensions in pulmonary sarcoidosis patients.

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Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

Abbreviations

CMR:

Cardiac magnetic resonance imaging

CS:

Cardiac sarcoidosis

EDV:

End-diastolic volume

EF:

Ejection fraction

ESV:

End-systolic volume

KBR:

Knowledge-based reconstruction

LGE:

Late gadolinium enhancement

PH:

Pulmonary hypertension

RV:

Right ventricular

SV:

Stroke volume

TTE:

Transthoracic echocardiography

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Funding

This work was supported by ZonMw (The Netherlands Organization for Health Research and Development).

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Author notes

  1. Harold Mathijssen and Marloes P. Huitema have contributed equally to this work

Authors and Affiliations

  1. Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands

    Harold Mathijssen, Marloes P. Huitema, Annelies L. M. Bakker, Fatima Akdim & Marco C. Post

  2. Department of Radiology, St. Antonius Hospital Nieuwegein/Utrecht, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands

    Hendrik W. van Es

  3. Department of Pulmonology, St. Antonius Hospital Nieuwegein/Utrecht, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands

    Jan C. Grutters

  4. Department of Pulmonology, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Jan C. Grutters

  5. Department of Cardiology, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Marco C. Post

Authors
  1. Harold Mathijssen
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Correspondence to Harold Mathijssen.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. The study was approved by the MEC-U Institutional Review Board (NL49594.100.14).

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Written informed consent was obtained from all patients included in the study.

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Written informed consent regarding the publication of the study data was obtained from all patients.

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Mathijssen, H., Huitema, M.P., Bakker, A.L.M. et al. Value of echocardiography using knowledge-based reconstruction in determining right ventricular volumes in pulmonary sarcoidosis: comparison with cardiac magnetic resonance imaging. Int J Cardiovasc Imaging 38, 309–316 (2022). https://doi.org/10.1007/s10554-021-02405-x

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  • DOI: https://doi.org/10.1007/s10554-021-02405-x

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