Clinical InvestigationRight Ventricular FunctionRelationship between Echocardiographic and Magnetic Resonance Derived Measures of Right Ventricular Size and Function in Patients with Pulmonary Hypertension
Section snippets
Patient Selection
A total of 45 patients with PH who underwent MRI and echocardiography between May 2007 and May 2012 were retrospectively considered for inclusion in the study. The diagnosis of PH was established using the World Health Organization criteria defined by a mean pulmonary arterial pressure > 25 mm Hg and a pulmonary capillary wedge pressure < 15 mm Hg. The majority had World Health Organization group I pulmonary arterial hypertension (n = 42), and three had World Health Organization group IV
Patient Characteristics
A total of 40 patients with PH were included in the study. The clinical characteristics, etiology of PH, relevant laboratory values, invasive hemodynamics, and medication profile are noted in Table 1. MRI and TTE parameters are listed in Table 2.
Relationship between Echocardiographic and MRI Measures of RV Size
Table 2 and Figure 3 summarize the relationship between echocardiographic and MRI measures of RV size. The best echocardiographic estimation of RV end-diastolic volume (RVEDV) was the RV end-diastolic area (RVEDA) measurement (R2 = 0.78, P < .001).
Discussion
Despite the complex shape of the right ventricle, in our study, both linear-based and area-based echocardiographic measures of RV size and function in patients with PH correlated well with MRI-derived RV volume and ejection fraction.
A limited number of studies have validated echocardiographic measures of RV function in patients with PH. Recently, Sato et al.7 showed that RVEF in patients with PH is best estimated by TAPSE compared with RVFAC. In contrast, using a larger cohort of patients with
Conclusions
We have shown that 2D echocardiography provides clinically useful measures of RV volume and ejection fraction in patients with PH, using MRI as the gold standard. Further studies will be needed to standardize the semiquantitative evaluation of RV size and function in patients with PH using 2D echocardiography. Future 3D echocardiographic methods for quantifying RVEDV or RVEF should also be compared with these simple linear or 2D indices in patients with PH.
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Drs Haddad and Yang are equivalent last authors.
This study was funded by the Stanford Cardiovascular Institute, Stanford School of Medicine (Stanford, CA). The Stanford University Division of Cardiovascular Medicine has a research agreement with GE Healthcare (Little Chalfont, United Kingdom).