Download Simple method of assessment of right ventricular systolic function by

Simple method of assessment of right ventricular systolic
function by conventional pulsed wave Doppler
Poster No.:
C-1314
Congress:
ECR 2014
Type:
Scientific Exhibit
Authors:
E. Mirzojan, N. Nelassov, D. Safonov, M. Babaev, O. Eroshenko,
M. N. Morgunov; Rostov-on-Don/RU
Keywords:
Staging, Echocardiography, Cardiac, Image registration
DOI:
10.1594/ecr2014/C-1314
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Aims and objectives
Right ventricle (RV) dysfunction has been associated with increased morbidity and
mortality in patients with congenital heart disease, valvular disease, coronary artery
disease, pulmonary hypertension, and heart failure [1].The right ventricle (RV) is often
neglected by echocardiographers because has a complex shape, less amenable to
geometric simplification for the purpose of volume estimation than the left ventricle.
Moreover, its endocardial surface is heavily trabeculated and difficult to trace accurately
for area measurements or volume calculations. The right ventricle is partly located behind
the sternum, which makes its visualisation by ultrasound difficult [2, 3]. In this study we
decided to analyze if measurement of tricuspid annular motion by conventional pulsed
wave Doppler can be utilized for assessment of RV SF.
Methods and materials
one hundred fifty six individuals were included in our study, out of which 77 were males
while 79 were females (mean age 53.4 ± 14.6 years, 65 healthy persons and 91 patients
with different cardiac pathology) underwent dopplerechocardiographic exam. Presence
of RV systolic dysfunction (SD) was determined by comprehensive approach (peak
systolic velocity of spectral tissue doppler sr' < 11 sm/s, fraction of RV area shortening in
4-chamber view < 40%, tricuspid annular peak systolic excursion < 19 mm). Conventional
pulsed wave Doppler was also used for registration of motion of lateral border of tricuspid
annulus (apical position of the probe, 4-chamber view) (Figure 1). Peak velocity of systolic
component of spectrogram (sr) was measured. Using the defined diagnosis of SD as a
referent method the cutoff value of sr for separation of patients without and with SD was
determined (Figure 2).
Statistica 6.0 (Stat Soft,USA) software was used for data management and statistical
analysis. Data are presented as mean±SD or frequency in number of observations,
scatterplots and correlative indices (r and p values).
Images for this section:
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Fig. 1: Position of the probe and sample volume and registered PW and TDI
spectrograms
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Results
In subjects with right ventricle systolic dysfunction mean value of sr was 12.1±2.1 cm/
s and in patients without SD 17.6±2.7 cm/s (p<.00001). The cutoff value of sr for
differentiation of patients with and without RV SD appeared to be < 14 cm/s (sensitivity
90.0%, specificity 91.2%) (Figure 3). In men mean value of sr was 17,7±3,0 cm/s, in
women-16,9±1,9 cm/s (Figure 4).
Images for this section:
Fig. 4: Mean value sr of men and women
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Fig. 2: Mean value sr of patients with SD and without right ventricle systolic dysfunction
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Fig. 3: Correlation between sr and sr'
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Conclusion
The study results showned, that conventional pulsed wave Doppler can be effectively
used for assessment of right ventricle systolic function.
Personal information
References
1.
2.
3.
Kenneth D. Horton et al. Assessment of the Right Ventricle by
Echocardiography: A Primer for Cardiac Sonographers // J. of the American
Society of Echocardiography - 2009. - Vol. 22. - #7. - P. 776-792
Kjaergaard J. et al. Assessment of Right Ventricular Systolic Function by
Tissue Doppler Echocardiography // Danisn medical J. - 2012. - Vol. 59. #3. - P. 1-29
Anthony S. McLean et al. The use of the right ventricular diameter and
tricuspid annular tissue Doppler velocity parameter to predict the presence
of pulmonary hypertension // Eur J. Echocardiogr - 2007. - Vol. 8. - #2. - P.
128-136
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