Affiliation:
1. Department of Cardiology, Erasmus MC University Medical Center Rotterdam , Dr. Molewaterplein 40, 3015 GD Rotterdam , The Netherlands
2. Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam , Rotterdam , The Netherlands
Abstract
Abstract
Aims
Advanced transthoracic echocardiography (TTE) using volumetric and deformational indices provides detailed quantification of right ventricular (RV) function in adults with congenital heart disease (ACHD). Two-dimensional multi-plane echocardiography (2D-MPE) has demonstrated regional wall differences in RV longitudinal strain (LS). This study aims to evaluate the association of these parameters with cardiovascular magnetic resonance (CMR).
Methods and results
One-hundred stable ACHD patients with primarily affected RVs were included (age 50 ± 5 years; 53% male). Conventional and advanced echocardiographic RV functional parameters were compared with CMR-derived RV function. Advanced echocardiographic RV functional parameters were measurable in approximately one-half of the study cohort, while multi-wall LS assessment feasibility was lower. CMR RV ejection fraction (CMR-RVEF) was moderately correlated with deformational, area, and volumetric parameters [RV global LS (lateral wall and septum), n = 55: r = −0.62, P < 0.001; RV wall average LS, n = 34: r = −0.49, P = 0.002; RV lateral wall LS, n = 56: r = −0.45, P < 0.001; fractional area change, n = 67: r = 0.48, P < 0.001; 3D-RVEF, n = 48: r = 0.40, P = 0.005]. Conventional measurements such as TAPSE and RV S′ correlated poorly. RV global LS best identified CMR-RVEF < 45% (area under the curve: 0.84, P < 0.001: cut-off value −19%: sensitivity 100%, specificity 57%). RVEF and LS values were significantly higher when measured by CMR compared with TTE (mean difference RVEF: 5 [−9 to 18] %; lateral (free) wall LS: −7 [7 to −21] %; RV global LS: −6 [5 to −16] %) while there was no association between respective LS values.
Conclusion
In ACHD patients, advanced echocardiographic RV functional parameters are moderately correlated with CMR-RVEF, although significant differences exist between indices measurable by both modalities.
Publisher
Oxford University Press (OUP)