The assessment of right ventricular structure and function in patients with different cardiovascular diseases using modern echocardiographic technologies and magnetic resonance imaging

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Abstract

Aim. To perform comparative analysis of right ventricular (RV) structure and function in patients with various cardiovascular diseases using modern echocardiographic technologies in comparison with magnetic resonance imaging (MRI).

Materials and methods. The study included 85 patients. Group 1 consisted of 32 patients with idiopathic pulmonary hypertension (IPH) (mean age 35.9±10.2 years). Group 2 included 27 patients with arterial hypertension (AH) grade 3 (mean age 58.6±12.3 years). Group 3 consisted of 26 patients with chronic heart failure (CHF) (mean age 56.1±15.3 years). Control group included 28 healthy volunteers (mean age 38.7±10.9 years). The main method was transthoracic echocardiography (TTE) using modern technologies, such as three-dimensional echocardiography (3DE), tissue Doppler imaging (TDI), and speckle tracking echocardiography (STE). In some patients and healthy volunteers 3DE data were compared with MRI data.

Results. Patients with IPH and CHF had minimal RV ejection fraction (EF) both according to 3DE and MRI. Correlation analysis revealed close correlation between RV volumes and EF according to 3DE and MRI. Minimal values of systolic indicator S’TV according to TDI were observed in patients with CHF. In all groups, including control group, the highest values of S’TV were obtained at the level of the basal segments and the lowest values at the level of apical segments. STE revealed the same pattern as TDI. According to STE minimal RV strain was observed in IPH and CHF groups and significantly differed not only from control group, but also from AH group.

Conclusion. The lowest values of RV EF and strain were observed in IPH and CHF groups. There were no significant differences in these indicators between the groups, that dictates the need for thorough assessment of RV structure and function not only in patients with precapillary, but also with postcapillary pulmonary hypertension. The results of the study confirm good comparability of 3DE and MRI in assessing RV volumes and EF.

About the authors

M. A. Saidova

Myasnikov Institute of Clinical Cardiology, National Medical Research Center for Cardiology

Author for correspondence.
Email: m.saidova@gmail.com
ORCID iD: 0000-0002-3233-1862

д.м.н., проф., рук. отд. ультразвуковых методов исследования ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

A. S. Loskutova

Pirogov First City Hospital

Email: m.saidova@gmail.com

врач-кардиолог ГБУЗ «ГКБ №1 им. Н.И. Пирогова»

Russian Federation, Moscow

A. A. Belevskaya

Myasnikov Institute of Clinical Cardiology, National Medical Research Center for Cardiology

Email: m.saidova@gmail.com
ORCID iD: 0000-0002-8029-5739

к.м.н., мл. науч. сотр. отд. ультразвуковых методов исследования ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

O. V. Stukalova

Myasnikov Institute of Clinical Cardiology, National Medical Research Center for Cardiology

Email: m.saidova@gmail.com
ORCID iD: 0000-0001-8377-2388

к.м.н., ст. науч. сотр. отд. томографии ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

References

  1. Sade AM, Castaneda AR. The dispensable right ventricle. Surgery. 1975;77(5):624-31.
  2. Bleasdale RA, Frenneaux MP. Prognostic importance of right ventricular dysfunction. Heart. 2002;88(4):323-4. doi: 10.1136/heart.88.4.323
  3. Hesse B, Asher CR. Time to move to the right: the study of right ventricular performance: too long neglected. Clin Cardiol. 2005;28:8-12. doi: 10.1002/clc.4960280104
  4. Polak JF, Holman BL, Wynne J, Colucci WS. Right ventricular ejection fraction: an indicator of increased mortality in patients with congestive heart failure associated with coronary artery disease. J Am Coll Cardiol. 1983;2(2):217-24. doi: 10.1016/s0735-1097(83)80156-9
  5. De Groote P, Millaire A, Foucher-Hossein C, et al. Right ventricular ejection fraction is an independent predictor of survival in patients with moderate heart failure. J Am Coll Cardiol. 1998;32(4):948-54. doi: 10.1016/s0735-1097(98)00337-4
  6. Bangalore S, Yao SS, Chaudhry FA. Role of right ventricular wall motion abnormalities in risk stratification and prognosis of patients referred for stress echocardiography. J Am Coll Cardiol. 2007;50(20):1981-9. doi: 10.1016/j.jacc.2007.07.061
  7. Sanchez O, Trinquart L, Colombet I, et al. Prognostic value of right ventricular dysfunction in patients with haemodynamically stable pulmonary embolism: a systematic review. Eur Heart J. 2008;29(12):1569-77. doi: 10.1093/eurheartj/ehn208
  8. Van Wolferen SA, Marcus JT, Boonstra A, et al. Prognostic value of right ventricular mass, volume, and function in idiopathic pulmonary arterial hypertension. Eur Heart J. 2007;28(10):1250-7. doi: 10.1093/eurheartj/ehl477
  9. Coutance G, Cauderlier E, Ehtisham J, et al. The prognostic value of markers of right ventricular dysfunction in pulmonary embolism: a meta-analysis. Crit Care. 2011;15(2):R103. doi: 10.1186/cc10119
  10. Starling MR, Crawford MH, Sorensen SG, et al. A new two dimensional echocardiographic technique for evaluating right ventricular size and performance in patients with obstructive lung disease. Circulation. 1982;66:612-20. doi: 10.1161/01.cir.66.3.612
  11. Watanabe T, Katsume H, Matsukubo H, et al. Estimation of right ventricular volume with two dimensional echocardiography. Am J Cardio. 1982;49:1946-53. doi: 10.1016/0002-9149(82)90214-4
  12. Horton KD, Meece RW, Hill JC. Assessment of the right ventricle by echocardiography: a primer for cardiac sonographers. J Am Soc Echocardiogr. 2009;22(7):776-92. doi: 10.1016/j.echo.2009.04.027
  13. Ghio S, Klersy C, Magrini G, et al. Prognostic relevance of the echocardiographic assessment of right ventricular function in patients with idiopathic pulmonary arterial hypertension. Int J Cardiol. 2010;140:272-8. doi: 10.1016/j.ijcard.2008.11.051
  14. Puwanant S, Priester TC, Mookadam F, et al. Right ventricular function in patients with preserved and reduced ejection fraction heart failure. Eur J Echocardiogr. 2009;10(6):733-7. doi: 10.1093/ejechocard/jep052
  15. Li Y, Wang Y, Zhai Z, et al. Real-Time Three-Dimensional Echocardiography to Assess Right Ventricle Function in Patients with Pulmonary Hypertension. PLoS One. 2015;10(6):e0129557. doi: 10.1371/journal.pone.0129557
  16. Magunia H, Dietrich C, Langer HF, et al. 3D echocardiography derived right ventricular function is associated with right ventricular failure and mid-term survival after left ventricular assist device implantation. Int J Cardiol. 2018;272:348-55. doi: 10.1016/j.ijcard.2018.06.026
  17. Gopal AS, Chukwu EO, Iwuchukwu CJ, et al. Normal values of right ventricular size and function by real-time 3-dimensional echocardiography: comparison with cardiac magnetic resonance imaging. J Am Soc Echocardiogr. 2007;20:445-55. doi: 10.1016/j.echo.2006.10.027

Supplementary files

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2. Fig. 1. An example of a system of measurements and RV EF according to 3D-EchoCG data in a patient with IPH: a - apical 4-chamber position; b - three-dimensional model of the pancreas.

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3. Fig. 2. Indicators of RV regional systolic function according to TMD and STE: a - at the level of basal segments; b - at the level of middle segments; c - at the level of the apical segments.

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4. Fig. 3. Indicators of RV regional diastolic function according to TMD and STE: a - at the level of basal segments; b - at the level of middle segments; c - at the level of the apical segments.

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