Three-dimensional echocardiography-based analysis of right ventricular shape in pulmonary arterial hypertension
| Autor: | Karima Addetia, Akhil Narang, Roberto M. Lang, Benjamin H. Freed, Lynn Weinert, Francesco Maffessanti, Victor Mor-Avi, Megan Yamat |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Right ventricular inflow tract view Heart Ventricles Hypertension Pulmonary Echocardiography Three-Dimensional Diastole 030204 cardiovascular system & hematology Curvature Sensitivity and Specificity Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests medicine.artery medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Aged Aged 80 and over Mean curvature Ventricular Remodeling Cardiac cycle business.industry General Medicine Anatomy Middle Aged medicine.disease Pulmonary hypertension Echocardiography Doppler medicine.anatomical_structure Ventricle Case-Control Studies Pulmonary artery Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal – Cardiovascular Imaging. 17:564-575 |
| ISSN: | 2047-2412 2047-2404 |
| DOI: | 10.1093/ehjci/jev171 |
| Popis: | Aims Right ventricular (RV) remodelling involves changes in size, function, and shape. Although three-dimensional echocardiography (3DE) allows imaging of RV morphology, regional RV shape analysis has not been evaluated using 3DE. We developed a technique to quantify RV shape and tested its ability to differentiate normal from pressure overloaded right ventricles. Methods Transthoracic 3DE RV images were acquired in 54 subjects, including 39 patients with pulmonary artery hypertension (PAH) and 15 normal controls (NL). 3D RV surfaces were reconstructed (TomTec) at end-diastole and end-systole (ED, ES) and processed using custom software to calculate mean curvature of the inflow and outflow tracts (RVIT, RVOT), apex, and body (both divided into free wall and septum). Methods and Results Septal segments (apical and body) in NLs were characterized by concavity (curvature 0) in ES. In PAH, however, the septum remained convex, bulging into the left ventricle throughout the cardiac cycle. In keeping with the ‘bellows-like’ action of RV contraction in the NL group, the body free wall transitioned from a convex surface at ED to a more flattened surface at ES, while the apex free wall progressed from a less convex surface at ED to a more convex surface at ES. In contrast, in PAH, both RV free-wall segments (apical and body) remained equally convex throughout the cardiac cycle. Conclusions Curvature analysis using 3D echocardiography allows quantitative evaluation of RV remodelling, which could be used to track differential changes in regional RV shape, as a way to assess disease progression or regression. |
| Databáze: | OpenAIRE |
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