Global longitudinal strain (GLS) consistently correlated with CMR-derived right ventricular ejection fraction (r = -0.73 at T1, r = -0.70 at T2) and demonstrated good interobserver reproducibility.
Cohort (n=14)
Blinded observers
No
Does echocardiographic assessment of systemic RV function correlate with CMR-derived systemic RVEF in adult patients with a systemic RV?
Global longitudinal strain is a robust and reproducible echocardiographic measurement of systemic RV function that correlates well with CMR-derived RVEF.
Effect estimate: r = -0.73
p-value: p=0.005
Background: Inherent to its geometry, echocardiographic imaging of the systemic right ventricle (RV) is challenging. Therefore, echocardiographic assessment of systemic RV function may not always be feasible and/or reproducible in daily practice. Here, we aim to validate the usefulness of a comprehensive range of 32 echocardiographic measurements of systemic RV function in a longitudinal cohort by serial assessment of their correlations with cardiac magnetic resonance (CMR)-derived systemic RV ejection fraction (RVEF). Methods: A single-center, retrospective cohort study was performed. Adult patients with a systemic RV who underwent a combination of both CMR and echocardiography at two different points in time were included. Off-line analysis of echocardiographic images was blinded to off-line CMR analysis and vice versa. In half of the echocardiograms, measurements were repeated by a second observer blinded to the results of the first. Correlations between echocardiographic and CMR measures were assessed with Pearson's correlation coefficient and interobserver agreement was quantified with intraclass correlation coefficients (ICC). Results: Fourteen patients were included, of which 4 had congenitally corrected transposition of the great arteries (ccTGA) and 10 patients had TGA late after an atrial switch operation. Eight patients (57%) were female. There was a mean of 8 years between the first and second imaging assessment. Only global systemic RV function, fractional area change (FAC), and global longitudinal strain (GLS) were consistently, i.e., at both time points, correlated with CMR-RVEF (global RV function: r = −0.77/ r = −0.63; FAC: r = 0.79/ r = 0.67; GLS: r = −0.73/ r = −0.70, all p -values 0.05). The ICC of GLS (0.82 at t = 1, p = 0.006, 0.77 at t = 2, p = 0.024) was higher than the ICC of FAC (0.35 at t = 1, p = 0.196, 0.70 at t = 2, p = 0.051) at both time points. Conclusion: GLS appears to be the most robust echocardiographic measurement of systemic RV function with good correlation with CMR-RVEF and reproducibility.
Zandstra et al. (Tue,) conducted a cohort in Systemic right ventricle (TGA after atrial switch or ccTGA) (n=14). Echocardiography (Global Longitudinal Strain) vs. Cardiac Magnetic Resonance (CMR) was evaluated on Correlation of Global Longitudinal Strain (GLS) with CMR-derived RVEF at time point 1 (r = -0.73, p=0.005). Global longitudinal strain (GLS) consistently correlated with CMR-derived right ventricular ejection fraction (r = -0.73 at T1, r = -0.70 at T2) and demonstrated good interobserver reproducibility.
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