Multi-parametric “on board” evaluation of right ventricular function using threedimensional
Background. Three-dimensional echocardiographic (3DE) of right ventricle (RV) has been validated in many clinical settings. However, the necessity of complicated and off–line dedicated softwares has reduced its diffusion. A new simplified “on board” 3DE software (OB) has been developed to obtain RV volumes and ejection fraction (EF) together with several conventional parameters automatically derived from 3DE: tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), longitudinal strain (LS). Aims of this study were to evaluate the feasibility and accuracy of RV analysis with OB in a large series of patients. Methods We studied 35 normals and 105 patients with different pathologies. Each patient underwent a complete 2DE and 3DE with OB 3DRV evaluation. Results were compared with the conventional off-line software (OFL) and with the 2D- derived corresponding values. A subgroup of 22 patients underwent also cardiac CMR. Results: OB RV reconstruction was feasible in 133/140 cases (95%). Imaging quality was good in 84%. Mean time for 3DE acquisition was 73.8±24 sec, for RV OB reconstruction 97,5±33 sec and for OFL analysis 129±52 sec (plus dataset loading 80±24 sec). OB and OFL 3DE RV volumes and EF were similar. 3DE derived FSA and LS (but not TAPSE) were similar to 2DE values and correlated with tissue Doppler systolic peak velocity, RV dP/dt, systolic pulmonary pressure and RV myocardial performance index. OB RV volumes and EF well correlated with CMR. (bias+SD: - 21.5±20 ml for EDV; -8.2±12.4 ml for ESV; -1± 5.9% for EF). Conclusion. OB 3DE method is feasible, simple, and time saving. It easily provides 3DE RV volumes and multiple functional parameters. Off-line operator border adjustment is actually recommended to obtain a more accurate 3DE derived TAPSE.