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A study to determine the contribution to right ventricle stroke volume from pulmonary and tricuspid valve displacement volumes
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Orebro University Hospital.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Clinical Physiology, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Orebro University Hospital. Department of Radiology.
Orebro University Hospital. Department of Medical Physics.ORCID iD: 0000-0002-8351-3367
2015 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 35, no 4, 283-290 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Describing the systolic function of the right ventricle (RV) is a difficult task due to the complex shape and orientation of the RV. The purpose of this study was to investigate the extent to which the volumes encompassed by the pulmonary and tricuspid valve displacements contribute to the total right ventricle stroke volume (RVSV).

METHODS: Twelve healthy volunteers were examined using cardiac magnetic resonance (CMR). Two series of time-resolved axially rotated MR images were acquired that encompassed the tricuspid valve and the pulmonary valve, respectively. The volume related to each valve movement, the tricuspid plane displacement (TPD) and the pulmonary plane displacement (PPD), was determined by delineation in diastole and systole. These volumes, RVSVTPD and RVSVPPD , were compared to the stroke volume to determine the contributions to the total stroke volume from the TPD and the PPD. The remaining volume of the total RVSV was referred to as RVSVOther . An initial in vitro study was carried out to validate the accuracy of volume measurements using axially rotated images.

RESULTS: In vitro measurements indicated that the method for volumetric measurements using axially rotated images was a very accurate one, with a mean difference of 0·04 ± 0·10 ml. The in vivo measurements of RVSVTPD , RVSVPPD and RVSVOther were 45 ± 10%, 13 ± 2% and 42 ± 11%, respectively.

CONCLUSIONS: Right ventricle stroke volume is determined by different individual volume changes as follows: RVSVTPD together with RVSVOther contributes to almost the entire RVSV in nearly equal proportions, while RVSVPPD contributes only a small amount and is approximately 30% of either RVSVTPD or RVSVOther.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015. Vol. 35, no 4, 283-290 p.
Keyword [en]
magnetic resonance imaging, pulmonary valve, right ventricle, stroke volume, tricuspid valve
National Category
Cardiac and Cardiovascular Systems Physiology
Research subject
Cardiology; Physiology
Identifiers
URN: urn:nbn:se:oru:diva-38860DOI: 10.1111/cpf.12162ISI: 000356312800006PubMedID: 24810859Scopus ID: 2-s2.0-84930746323OAI: oai:DiVA.org:oru-38860DiVA: diva2:764916
Note

Funding Agencies:

Örebro County Council

European Union - European Regional Development Fund

Available from: 2014-11-20 Created: 2014-11-20 Last updated: 2017-03-27Bibliographically approved
In thesis
1. On the assessment of right ventricular function using cardiac magnetic resonance imaging and echocardiography
Open this publication in new window or tab >>On the assessment of right ventricular function using cardiac magnetic resonance imaging and echocardiography
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) imaging are two commonly used imaging modalities for evaluating the size and function of the heart. There are advantages and disadvantages associated with both modalities when examining the right ventricle (RV).

The RV is positioned partly behind the sternum and lung, sometimes causing shadows in the TTE images. This along with the complex shape of the RV makes volume calculations challenging by 2D TTE. CMR is considered to be the reference method for volume calculations of the ventricles. The valve separating the RV from the right atrium is however often oblique compared to the valve separating the left ventricle from the left atrium. This complicates RV volume calculations using conventional CMR short-axis stack images. The aim of this thesis was to find ways to improve the RV stroke volume and ejection fraction calculations using TTE and CMR.

A method, transferring the position of the tricuspid plane from RV long-axis images to short-axis images, was developed to improve the separation of the right atrium from the RV when calculating RV stroke volumes by CMR. The method provided calculations of RV stroke volumes with good agreement to reference volumes. Further, the movements contributing to the RV stroke volume was studied aiming to find new ways of calculating RV stroke volumes and ejection fraction by TTE. A model for RV stroke volume and ejection fraction calculations was evaluated showing underestimation of stroke volumes by TTE compared to CMR, which probably depend on differences in distance measurements using the two modalities. The model provided, however, promising results for ejection fraction calculations which was validated in a study of 37 participants that covered a wide range of EF.

Place, publisher, year, edition, pages
Örebro: Örebro university, 2016. 79 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 152
Keyword
right ventricle, stroke volume, ejection fraction, cardiac magnetic resonance, ehocardiography
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-51662 (URN)978-91-7529-158-1 (ISBN)
Public defence
2016-11-18, Universitetssjukhuset, hörsal C3, Södra Grev Rosengatan, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2016-08-15 Created: 2016-08-15 Last updated: 2016-12-12Bibliographically approved

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