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Right ventricular ejection fraction measurements using two-dimensional transthoracic echocardiography by applying an ellipsoid model

BACKGROUND: There is today no established approach to estimate right ventricular ejection fraction (RVEF) using 2D transthoracic echocardiography (TTE). The aim of this study was to evaluate a new method for RVEF calculations using 2D TTE and compare the results with cardiac magnetic resonance (CMR)...

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Autores principales: Jorstig, Stina, Waldenborg, Micael, Lidén, Mats, Thunberg, Per
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5341471/
https://www.ncbi.nlm.nih.gov/pubmed/28270161
http://dx.doi.org/10.1186/s12947-017-0096-5
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author Jorstig, Stina
Waldenborg, Micael
Lidén, Mats
Thunberg, Per
author_facet Jorstig, Stina
Waldenborg, Micael
Lidén, Mats
Thunberg, Per
author_sort Jorstig, Stina
collection PubMed
description BACKGROUND: There is today no established approach to estimate right ventricular ejection fraction (RVEF) using 2D transthoracic echocardiography (TTE). The aim of this study was to evaluate a new method for RVEF calculations using 2D TTE and compare the results with cardiac magnetic resonance (CMR) imaging and tricuspid annular plane systolic excursion (TAPSE). METHODS: A total of 37 subjects, 25 retrospectively included patients and twelve healthy volunteers, were included to give a wide range of RVEF. The right ventricle (RV) was modeled as a part of an ellipsoid enabling calculation of the RV volume by combining three distance measurements. RVEF calculated according to the model, RVEF(TTE), were compared with reference CMR-derived RVEF, RVEF(CMR). Further, TAPSE was measured in the TTE images and the correlations were calculated between RVEF(TTE), TAPSE and RVEF(CMR). RESULTS: The mean values were RVEF(CMR) = 43 ± 12% (range 20–66%) and RVEF(TTE) = 50 ± 9% (range 34–65%). There was a high correlation (r = 0.80, p < 0.001) between RVEF(TTE) and RVEF(CMR). Bland-Altman analysis showed a mean difference between RVEF(CMR) and RVEF(TTE) of 6 percentage points (ppt) with limits of agreement from −11 to 23 ppt. The mean value for TAPSE was 19 ± 5 mm and the correlation between TAPSE and RVEF(CMR) was moderate (r = 0.54, p < 0.001). The correlation between RVEF(TTE) and RVEF(CMR) was significantly higher (p < 0.05) than the correlation between TAPSE and RVEF(CMR). CONCLUSIONS: The ellipsoid model shows promise for RVEF calculations using 2D TTE for a wide range of RVEF, providing RVEF estimates that were significantly better correlated to RVEF obtained from CMR compared to TAPSE. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12947-017-0096-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-53414712017-03-10 Right ventricular ejection fraction measurements using two-dimensional transthoracic echocardiography by applying an ellipsoid model Jorstig, Stina Waldenborg, Micael Lidén, Mats Thunberg, Per Cardiovasc Ultrasound Research BACKGROUND: There is today no established approach to estimate right ventricular ejection fraction (RVEF) using 2D transthoracic echocardiography (TTE). The aim of this study was to evaluate a new method for RVEF calculations using 2D TTE and compare the results with cardiac magnetic resonance (CMR) imaging and tricuspid annular plane systolic excursion (TAPSE). METHODS: A total of 37 subjects, 25 retrospectively included patients and twelve healthy volunteers, were included to give a wide range of RVEF. The right ventricle (RV) was modeled as a part of an ellipsoid enabling calculation of the RV volume by combining three distance measurements. RVEF calculated according to the model, RVEF(TTE), were compared with reference CMR-derived RVEF, RVEF(CMR). Further, TAPSE was measured in the TTE images and the correlations were calculated between RVEF(TTE), TAPSE and RVEF(CMR). RESULTS: The mean values were RVEF(CMR) = 43 ± 12% (range 20–66%) and RVEF(TTE) = 50 ± 9% (range 34–65%). There was a high correlation (r = 0.80, p < 0.001) between RVEF(TTE) and RVEF(CMR). Bland-Altman analysis showed a mean difference between RVEF(CMR) and RVEF(TTE) of 6 percentage points (ppt) with limits of agreement from −11 to 23 ppt. The mean value for TAPSE was 19 ± 5 mm and the correlation between TAPSE and RVEF(CMR) was moderate (r = 0.54, p < 0.001). The correlation between RVEF(TTE) and RVEF(CMR) was significantly higher (p < 0.05) than the correlation between TAPSE and RVEF(CMR). CONCLUSIONS: The ellipsoid model shows promise for RVEF calculations using 2D TTE for a wide range of RVEF, providing RVEF estimates that were significantly better correlated to RVEF obtained from CMR compared to TAPSE. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12947-017-0096-5) contains supplementary material, which is available to authorized users. BioMed Central 2017-03-07 /pmc/articles/PMC5341471/ /pubmed/28270161 http://dx.doi.org/10.1186/s12947-017-0096-5 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Jorstig, Stina
Waldenborg, Micael
Lidén, Mats
Thunberg, Per
Right ventricular ejection fraction measurements using two-dimensional transthoracic echocardiography by applying an ellipsoid model
title Right ventricular ejection fraction measurements using two-dimensional transthoracic echocardiography by applying an ellipsoid model
title_full Right ventricular ejection fraction measurements using two-dimensional transthoracic echocardiography by applying an ellipsoid model
title_fullStr Right ventricular ejection fraction measurements using two-dimensional transthoracic echocardiography by applying an ellipsoid model
title_full_unstemmed Right ventricular ejection fraction measurements using two-dimensional transthoracic echocardiography by applying an ellipsoid model
title_short Right ventricular ejection fraction measurements using two-dimensional transthoracic echocardiography by applying an ellipsoid model
title_sort right ventricular ejection fraction measurements using two-dimensional transthoracic echocardiography by applying an ellipsoid model
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5341471/
https://www.ncbi.nlm.nih.gov/pubmed/28270161
http://dx.doi.org/10.1186/s12947-017-0096-5
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