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Determination of Right Ventricular Volume by Combining Echocardiographic Distance Measurements
Örebro University, School of Medical Sciences.
Örebro University, School of Health Sciences. Department of Clinical Physiology, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0002-4262-6373
Örebro University, School of Medical Sciences. Department of Radiology, Örebro University Hospital, Örebro, Sweden.
Department of Clinical Physiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
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2016 (English)In: Echocardiography, ISSN 0742-2822, E-ISSN 1540-8175, Vol. 33, no 6, p. 844-853Article in journal (Refereed) Published
Abstract [en]

Background: The position of the right ventricle (RV), often partly behind the sternum, implies difficulties to image the RV free wall using transthoracic echocardiography (TTE) and consequently limits the possibilities of stroke volume calculations. The aim of this study was to evaluate whether the volume of the right ventricle (RV) can be determined by combining TTE distance measurements that do not need the RV free wall to be fully visualized.

Methods: The RV volume was approximated by an ellipsoid composed of three distances. Distance measurements, modeled RV stroke volumes (RVSV), and RV ejection fraction (RVEF) were compared to reference values obtained from cardiac magnetic resonance (CMR) imaging for 12 healthy volunteers.

Results: Inter-modality comparisons showed that distance measurements were significantly underestimated in TTE compared to CMR. The modeled RV volumes using TTE distance measurements were underestimated compared to reference CMR volumes. There was, however, for TTE an agreement between modeled RVSV and left ventricular stroke volumes determined by biplane Simpson's rule. Similar agreement was shown between modeled RVSV based on CMR distance measurements and the CMR reference. Regarding RVEF, further studies including patients with a wider range of RVEF are needed to evaluate the method.

Conclusion: In conclusion, the ellipsoid model of the RV provides good estimates of RVSVs, but volumes based on distance measurements from different modalities cannot be used interchangeably.

Place, publisher, year, edition, pages
Hoboken, USA: Wiley-Blackwell Publishing Inc., 2016. Vol. 33, no 6, p. 844-853
Keywords [en]
Right ventricle, right ventricular volume, ejection fraction, echoc ardiography, cardiac magnetic resonance imaging
National Category
Cardiac and Cardiovascular Systems
Research subject
Cardiology
Identifiers
URN: urn:nbn:se:oru:diva-50370DOI: 10.1111/echo.13173ISI: 000379944600005PubMedID: 26841195Scopus ID: 2-s2.0-84975297303OAI: oai:DiVA.org:oru-50370DiVA, id: diva2:930260
Note

Funding Agency:

Örebro County Council

Available from: 2016-05-23 Created: 2016-05-23 Last updated: 2018-07-10Bibliographically 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. p. 79
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 152
Keywords
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)
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Supervisors
Available from: 2016-08-15 Created: 2016-08-15 Last updated: 2017-10-17Bibliographically approved

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Hellstrandh Jorstig, StinaWaldenborg, MicaelLidén, MatsThunberg, Per

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