Knowledge-based 3D reconstruction of the right ventricle: comparison with cardiac magnetic resonance in adults with congenital heart disease
Echo Research & Practice volume 2, pages 109–116 (2015)
Aim: Assessment of right ventricular (RV) function is a challenge, especially in patients with congenital heart disease (CHD). The aim of the present study is to assess whether knowledge-based RV reconstruction, used in the everyday practice of an echo-lab for adult CHD in a tertiary referral center, is accurate when compared to cardiac magnetic resonance (CMR) examination.
Subjects and methods: Adult patients who would undergo CMR for assessment of the RV were asked to undergo an echo of the heart for further knowledge-based reconstruction (KBR). Echocardiographic images were acquired in standard views using a predefined imaging protocol. RV volumes and ejection fraction (EF) calculated using knowledge-based technology were compared with the CMR data of the same patient.
Results: Nineteen consecutive patients with congenital right heart disease were studied. Median age of the patients was 28 years (range 46 years). Reconstruction was possible in 16 out of 19 patients (85%). RV volumes assessed with this new method were smaller than with CMR. Indexed end diastolic volumes were 114±17 ml vs 121±19 ml, P<0.05 and EFs were 45±8% vs 47±9%, P<0.05 respectively. The correlation between the methods was good with an intraclass correlation of 0.84 for EDV and 0.89 for EF, P value <0.001 in both cases.
Conclusion: KBR enables reliable measurement of RVs in patients with CHDs and can be used in clinical practice for analysis of volumes and EFs.
Baumgartner H, Bonhoeffer P, De Groot NM, de Haan F, Deanfield JE, Galie N, Gatzoulis MA, Gohlke-Baerwolf C, Kaemmerer H, Kilner P, et al. 2010 ESC guidelines for the management of grown-up congenital heart disease (new version 2010). European Heart Journal 31 2915–2957. (doi:10.1093/eurheartj/ehq249)
Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, & Schiller NB 2010 Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. Journal of the American Society of Echocardiography 23 685–713. (quiz 86–88) (doi:10.1016/j.echo.2010.05.010)
Haddad F, Doyle R, Murphy DJ, & Hunt SA 2008 Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation 117 1717–1731. (doi:10.1161/CIRCULATIONAHA.107.653584)
Sugeng L, Mor-Avi V, Weinert L, Niel J, Ebner C, Steringer-Mascherbauer R, Bartolles R, Baumann R, Schummers G, Lang RM, et al. 2010 Multimodality comparison of quantitative volumetric analysis of the right ventricle. JACC. Cardiovascular Imaging 3 10–18. (doi:10.1016/j.jcmg.2009.09.017)
Knauth AL, Gauvreau K, Powell AJ, Landzberg MJ, Walsh EP, Lock JE, del Nido PJ, & Geva T 2008 Ventricular size and function assessed by cardiac MRI predict major adverse clinical outcomes late after Tetralogy of Fallot repair. Heart 94 211–216. (doi:10.1136/hrt.2006.104745)
van der Zwaan HB, Helbing WA, McGhie JS, Geleijnse ML, Luijnenburg SE, Roos-Hesselink JW, & Meijboom FJ 2010 Clinical value of real-time three-dimensional echocardiography for right ventricular quantification in congenital heart disease: validation with cardiac magnetic resonance imaging. Journal of the American Society of Echocardiography 23 134–140. (doi:10.1016/j.echo.2009.12.001)
Sheehan FH, Kilner PJ, Sahn DJ, Vick GW III, Stout KK, Ge S, Helbing WA, Lewin M, Shurman AJ, Buechel EV, et al. 2010 Accuracy of knowledge-based reconstruction for measurement of right ventricular volume and function in patients with Tetralogy of Fallot. American Journal of Cardiology 105 993–999. (doi:10.1016/j.amjcard.2009.11.032)
Dragulescu A, Grosse-Wortmann L, Fackoury C, & Mertens L 2012 Echocardiographic assessment of right ventricular volumes: a comparison of different techniques in children after surgical repair of Tetralogy of Fallot. European Heart Journal Cardiovascular Imaging 13 596–604. (doi:10.1093/ejechocard/jer278)
Bhave NM, Patel AR, Weinert L, Yamat M, Freed BH, Mor-Avi V, Gomberg-Maitland M, & Lang RM 2013 Three-dimensional modeling of the right ventricle from two-dimensional transthoracic echocardiographic images: utility of knowledge-based reconstruction in pulmonary arterial hypertension. Journal of the American Society of Echocardiography 26 860–867. (doi:10.1016/j.echo.2013.05.007)
Kutty S, Li L, Polak A, Gribben P, & Danford DA 2012 Echocardiographic knowledge-based reconstruction for quantification of the systemic right ventricle in young adults with repaired D-transposition of great arteries. American Journal of Cardiology 109 881–888. (doi:10.1016/j.amjcard.2011.11.012)
Dragulescu A, Grosse-Wortmann L, Fackoury C, Riffle S, Waiss M, Jaeggi E, Yoo SJ, Friedberg MK, & Mertens L 2011 Echocardiographic assessment of right ventricular volumes after surgical repair of Tetralogy of Fallot: clinical validation of a new echocardiographic method. Journal of the American Society of Echocardiography 24 1191–1198. (doi:10.1016/j.echo.2011.08.006)
Laser KT, Horst JP, Barth P, Kelter-Klopping A, Haas NA, Burchert W, Kececioglu D, & Körperich H 2014 Knowledge-based reconstruction of right ventricular volumes using real-time three-dimensional echocardiographic as well as cardiac magnetic resonance images: comparison with a cardiac magnetic resonance standard. Journal of the American Society of Echocardiography 27 1087–1097. (doi:10.1016/j.echo.2014.05.008)
Gopal AS, Chukwu EO, Iwuchukwu CJ, Katz AS, Toole RS, Schapiro W, & Reichek N 2007 Normal values of right ventricular size and function by real-time 3-dimensional echocardiography: comparison with cardiac magnetic resonance imaging. Journal of the American Society of Echocardiography 20 445–455. (doi:10.1016/j.echo.2006.10.027)
Bonnemains L, Stos B, Vaugrenard T, Marie PY, Odille F, & Boudjemline Y 2012 Echocardiographic right ventricle longitudinal contraction indices cannot predict ejection fraction in post-operative Fallot children. European Heart Journal Cardiovascular Imaging 13 235–242. (doi:10.1093/ejechocard/jer263)
Bove EL, Byrum CJ, Thomas FD, Kavey RE, Sondheimer HM, Blackman MS, Parker FB, Jr 1983 The influence of pulmonary insufficiency on ventricular function following repair of Tetralogy of Fallot. Evaluation using radionuclide ventriculography. Journal of Thoracic and Cardiovascular Surgery 85 691–696.
Geva T 2006 Indications and timing of pulmonary valve replacement after Tetralogy of Fallot repair. Seminars in Thoracic and Cardiovascular Surgery 9 11–22. (doi:10.1053/j.pcsu.2006.02.009)
Pattynama PM, Lamb HJ, Van der Velde EA, Van der Geest RJ, Van der Wall EE, & De Roos A 1995 Reproducibility of MRI-derived measurements of right ventricular volumes and myocardial mass. Magnetic Resonance Imaging 13 53–63. (doi:10.1016/0730-725X(94)00076-F)
Winter MM, Romeih S, Bouma BJ, Groenink M, Blom NA, Spijkerboer AM, & Mulder BJ 2012 Is cardiac CT a reproducible alternative for cardiac MR in adult patients with a systemic right ventricle? Netherlands Heart Journal 20 456–462. (doi:10.1007/s12471-012-0310-x)
Catalano O, Antonaci S, Opasich C, Moro G, Mussida M, Perotti M, Calsamiglia G, Frascaroli M, Baldi M, & Cobelli F 2007 Intra-observer and interobserver reproducibility of right ventricle volumes, function and mass by cardiac magnetic resonance. Journal of Cardiovascular Medicine 8 807–814. (doi:10.2459/JCM.0b013e32801105ef)
Grothues F, Moon JC, Bellenger NG, Smith GS, Klein HU, & Pennell DJ 2004 Interstudy reproducibility of right ventricular volumes, function, and mass with cardiovascular magnetic resonance. American Heart Journal 147 218–223. (doi:10.1016/j.ahj.2003.10.005)
Luijnenburg SE, Robbers-Visser D, Moelker A, Vliegen HW, Mulder BJ, & Helbing WA 2010 Intra-observer and interobserver variability of biventricular function, volumes and mass in patients with congenital heart disease measured by CMR imaging. International Journal of Cardiovascular Imaging 26 57–64. (doi:10.1007/s10554-009-9501-y)
Acknowledgments to the staff at the echo lab at the Department of Cardiology, University Medical Center Utrecht, The Netherlands for their help and cooperation and to all co-authors for their critical comments during the work with this manuscript.
This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
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Trzebiatowska-Krzynska, A., Driessen, M., Sieswerda, G.T. et al. Knowledge-based 3D reconstruction of the right ventricle: comparison with cardiac magnetic resonance in adults with congenital heart disease. Echo Res Pract 2, 109–116 (2015). https://doi.org/10.1530/ERP-15-0029