Circulation, Vol 89, 2342-2350, Copyright © 1994 by American Heart Association
L Jiang, SC Siu, MD Handschumacher, J Luis Guererro, JA Vazquez de Prada, ME King, MH Picard, AE Weyman and RA Levine
BACKGROUND: Current two-dimensional echocardiographic measures of right
ventricular volume are limited by the asymmetrical and crescentic shape of
the ventricle and by difficulty in obtaining standardized views.
Three-dimensional echocardiographic reconstruction, which does not require
geometric assumptions or standardized views, may therefore have potential
advantages for determining right ventricular volume. Three- dimensional
techniques, however, have not been applied to the right ventricle in vivo,
where cardiac motion and contraction could affect accuracy. The purpose of
this study was to determine the feasibility and accuracy of
three-dimensional echocardiographic reconstruction for quantifying right
ventricular volume and function in vivo. In particular, it was designed to
test the accuracy of a newly developed system that provides rapid,
efficient, and automated three-dimensional data collection (minimizing
motion effects) and takes advantage of the full three-dimensional data set
to obtain volume. METHODS AND RESULTS: The three-dimensional system was
applied to reconstruct the right ventricle and measure its volume and
function during 20 hemodynamic stages created in five dogs. Actual
instantaneous volumes were measured continuously by an intracavitary
balloon connected to an external column. Hemodynamics were varied by volume
loading and induction of ischemia. Three-dimensional reconstruction
successfully reproduced right ventricular volume compared with actual
values at end diastole (y = 1.0 chi-3.4, r = .99, SEE = 1.8 mL) and end
systole (y = 1.0 chi+ 2.0, 4 = .98, SEE = 2.5 mL). The mean difference
between calculated and actual volumes throughout the cycle was 2.1 mL, or
4.9% of the mean. Ejection fraction also correlated well with actual values
(y = 0.96 chi- 0.3, r = .98, SEE = 3.3%). CONCLUSIONS: Despite the
irregular crescentic shape of the right ventricle, this newly developed
three- dimensional system and surfacing algorithm can accurately
reconstruct its shape and quantitate its volume and function in vivo
without geometric assumptions. The increased efficiency of the system
should increase applicability to issues of clinical and research interest.
ARTICLES
Three-dimensional echocardiography. In vivo validation for right ventricular volume and function
Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114.
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