Assessment of right ventricular systolic function: Comparison between cardiac magnetic resonance derived ejection fraction and pulsed-wave tissue Doppler imaging of the tricuspid annulus

• Published in: International journal of cardiology 2011-08, Vol.151 (1), p.58-62
• Main Authors: Wahl, Andreas, Praz, Fabien, Schwerzmann, Markus, Bonel, Harald, Koestner, Simon C, Hullin, Roger, Schmid, Jean-Paul, Stuber, Thomas, Delacrétaz, Etienne, Hess, Otto M, Meier, Bernhard, Seiler, Christian
• Format: Article
• Language: English
• Subjects: Adult; Assessment; Biological and medical sciences; Cardiology. Vascular system; Cardiomyopathy, Dilated - diagnostic imaging; Cardiomyopathy, Dilated - pathology; Cardiomyopathy, Dilated - physiopathology; Cardiovascular; Cardiovascular magnetic resonance; Cardiovascular system; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - pathology; Coronary Artery Disease - physiopathology; Echocardiography; Echocardiography, Doppler, Pulsed - methods; Echocardiography, Doppler, Pulsed - standards; Ejection fraction; Female; Heart Defects, Congenital - diagnostic imaging; Heart Defects, Congenital - pathology; Heart Defects, Congenital - physiopathology; Heart Diseases - diagnostic imaging; Heart Diseases - pathology; Heart Diseases - physiopathology; Humans; Hypertension, Pulmonary - diagnostic imaging; Hypertension, Pulmonary - pathology; Hypertension, Pulmonary - physiopathology; Investigative techniques of hemodynamics; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging - methods; Magnetic Resonance Imaging - standards; Male; Medical sciences; Middle Aged; Predictive Value of Tests; Reproducibility of Results; Right ventricular systolic function; Sensitivity and Specificity; Stroke Volume - physiology; Systole - physiology; Tissue Doppler imaging; Tricuspid Valve - diagnostic imaging; Tricuspid Valve - pathology; Tricuspid Valve - physiology; Ultrasonic investigative techniques; Validation; Ventricular Function, Right - physiology
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2010.04.089

Abstract Background Systolic right ventricular (RV) function is an important predictor in the course of various congenital and acquired heart diseases. Its practical determination by echocardiography remains challenging. We compared routine assessment of lateral tricuspid annular systolic motion velocity (TVlat , cm/s) using pulsed-wave tissue Doppler imaging from the apical 4-chamber view with cardiac magnetic resonance (CMR) as reference method. Methods and results 254 individuals (43 ± 18 years) underwent both CMR (contiguous short axis slices; retrogated cine steady state free precession technique; manual contour tracing) and echocardiography within 2 ± 2 months. Seventy-five had coronary artery disease, 87 congenital heart disease, 17 dilated cardiomyopathy, 15 pulmonary artery hypertension, and 47 normal findings. RV ejection fraction (EF) by CMR was 51 ± 12% (range 17–78%). There was a linear correlation between RVEF and TVlat ( r = 0.60; p < 0.0001). A TVlat cut-off of 12 cm/s identified patients with normal EF (≥ 50%) with 81% sensitivity and 68% specificity, and a threshold of TVlat < 9 cm/s identified patients with severely reduced RVEF (< 30%) with 82% sensitivity and 86% specificity. Conclusions Systolic long-axis velocity measurements of the lateral tricuspid annulus allow a reliable assessment of RVEF in clinical routine. A threshold of TVlat < 9 cm/s identifies patients with severely reduced RVEF (< 30%) with high sensitivity and specificity.