Key result
The 2D transthoracic echocardiography ellipsoid model provided right ventricular ejection fraction estimates that strongly correlated with cardiac magnetic resonance (r=0.80, p<0.001), performing significantly better than TAPSE.
Why the study?
Does an ellipsoid model for 2D TTE improve the correlation of RVEF estimates with CMR compared to TAPSE in subjects with a wide range of RVEF?
Cross-Sectional (n=37)
No
Does an ellipsoid model for 2D TTE improve the correlation of RVEF estimates with CMR compared to TAPSE in subjects with a wide range of RVEF?
An ellipsoid model using 2D TTE provides RVEF estimates that correlate significantly better with CMR-derived RVEF than standard TAPSE measurements.
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). 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 . 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 . 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.
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Jorstig et al. (2017) conducted a cross-sectional in Reduced right ventricular function (n=37). 2D TTE ellipsoid model for RVEF calculation vs. Cardiac magnetic resonance (CMR) and TAPSE was evaluated on Correlation between RVEF calculated by the 2D TTE ellipsoid model and CMR-derived RVEF (r = 0.80, p=<0.001). The 2D transthoracic echocardiography ellipsoid model provided right ventricular ejection fraction estimates that strongly correlated with cardiac magnetic resonance (r=0.80, p<0.001), performing significantly better than TAPSE.
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