Is three-dimensional transthoracic echocardiography feasible for evaluating right ventricular volumes compared to left ventricular values in children with normal cardiac anatomy?
Three-dimensional echocardiography with dedicated software is feasible for right ventricular volume quantification in children, showing higher end-diastolic volumes and lower ejection fractions compared to the left ventricle.
BACKGROUND: Three-dimensional echocardiography (3DE) allows accurate estimation of left ventricular (LV) volumes and function in children. Because of the peculiar morphology of the right ventricle (RV), RV volumes and function assessment remain challenging. 3D software adapted for RV morphology is a promising noninvasive method. AIMS: The aims of this study were to evaluate the feasibility of 3D RV analysis in a normal pediatric population and to compare 3D RV to 3D LV measurements. PATIENTS AND METHODS: 3D transthoracic echocardiography was performed in 50 patients (mean age 9.5 years ± 5.1) with normal cardiac anatomy and function. Measurements were performed with the X3-1 or the X7-2 matrix probe (iE33, Philips Medical Systems, Andover, MA, USA). Ventricular volumes were analyzed with dedicated analysis software (TomTec Imaging Systems, Munich, Germany). RESULTS: Measurements were possible in 100% of LVs and 94% of RVs. The stroke volumes of the two ventricles correlated well (r = 0.81 95% CI, 0.68-0.89, P < 0.0001) with a mean difference of 3.6 mL (±9.2). Compared to the LV, the RV had higher mean end-diastolic volume (53 mL ±29 versus 46 mL ±46, P = 0.020) and end-systolic volume (29 mL ±17 versus 17 mL ±12, P < 0.0001) but lower mean ejection fraction (49%±8 versus 67%±10, P < 0.0001). CONCLUSION: 3DE using dedicated software is a feasible and reproducible method for RV volume quantification in children with normal hearts. Further studies are needed to validate the accuracy of the measurements.
Séguéla et al. (2011) studied this question.