Key result
Three-dimensional echocardiography significantly underestimated right ventricular end-diastolic volume by 38% (mean difference -47.47 ml) compared to cardiac magnetic resonance in children.
Why the study?
The role of three-dimensional echocardiography chamber quantification in children is still underestimated.
Does three-dimensional echocardiography accurately measure left and right ventricular volumes compared to cardiac magnetic resonance in children?
Observational (n=43)
Single-blind
No
Does three-dimensional echocardiography accurately measure left and right ventricular volumes compared to cardiac magnetic resonance in children?
Mean Difference: -47.47 (95% CI -58.31–-36.63)
Absolute Event Rate: 104.4% vs 153.08%
p-value: p=<0.000001
3D-ECHO is a reliable tool for assessing left ventricular volumes in children, but it significantly underestimates right ventricular volumes compared to CMR, requiring the use of specific correction coefficients to ensure accuracy.
Clinicians should exercise caution with 3D echocardiography for right ventricular assessment in children; leaves open need for further validation.
Introduction The role of three-dimensional echocardiography (3D-ECHO) chamber quantification in children is still underestimated. Material and methods In 43 children 3D-ECHO measurements of end-diastolic (EDV) and end-systolic ventricular volumes (ESV) were compared to cardiac magnetic resonance (CMR) using Bland-Altman analysis and linear regression. The values of left and right ventricular volumes calculated in 3D-ECHO were compared with each other and verified by CMR. Results The values of LV-EDV and LV-ESV measured in 3D-ECHO showed highly significant correlations with CMR (for LV-EDV r = 0.892, p < 0.00001; for LV-ESV r = 0.896, p < 0.00001). In the case of the right ventricle the correlation of 3D-ECHO results with CMR was still high (RV-EDV r = 0.848, p < 0.00001, RV-ESV r = 0.914, p < 0.00001), although mean RV-EDV and RV-ESV in 3D-ECHO were underestimated compared to CMR (by 38% for RV-EDV and 45% for RV-ESV). Correction of 3D-ECHO results using the coefficient of 1.38 and 1.45 for RV-EDV and RV-ESV, respectively, significantly improved the consistency of the results with CMR. 3D-ECHO offered lower mean values of right ventricular volumes compared to the left ventricle. The discrepancy was again reduced by the calculated coefficients. Conclusions 3D-ECHO is a valuable tool for assessment of left ventricular volume, which strongly correlates and agrees with CMR. The right ventricular volumes calculated in 3D-ECHO tend to be significantly underestimated in comparison to CMR and corresponding left ventricular volumes obtained from 3D-ECHO. The use of coefficients developed by the study improves the consistency of right ventricular volumes measured by 3D-ECHO with results obtained by CMR and reduces the volumetric discrepancy between ventricles in 3D-ECHO.
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Kamińska et al. (2019) conducted an observational in Various pediatric cardiac conditions (arrhythmia, cardiomyopathy, suspected myocarditis) (n=43). Three-dimensional echocardiography (3D-ECHO) vs. Cardiac magnetic resonance (CMR) was evaluated on Right ventricular end-diastolic volume (RV-EDV) (MD -47.47 ml, 95% CI -58.31 to -36.63, p=<0.000001). Three-dimensional echocardiography significantly underestimated right ventricular end-diastolic volume by 38% (mean difference -47.47 ml) compared to cardiac magnetic resonance in children.
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