Kai Thorsten Laser1, Ayşe Karabiyik2, Hermann Körperich3, Jan-Pit Horst4, Peter Barth3, Deniz Kececioglu4, Wolfgang Burchert3, Robert DallaPozza5, Ulrike Herberg6. 1. Center for Congenital Heart Defects, Heart and Diabetes Center North-Rhine-Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany. Electronic address: tlaser@hdz-nrw.de. 2. Center for Congenital Heart Defects, Heart and Diabetes Center North-Rhine-Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany; Clinic for Anesthesiology, Intensive Care and Pain Therapy, North Rhine-Westphalia, Ruhr-University of Bochum, University Medical Center Knappschaftskrankenhaus Bochum, Langendreer, Bochum, Germany. 3. Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine-Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany. 4. Center for Congenital Heart Defects, Heart and Diabetes Center North-Rhine-Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany. 5. Department of Pediatric Cardiology, Ludwig Maximilian University of Munich, Munich, Germany. 6. Department of Pediatric Cardiology, University of Bonn, Bonn, Germany.
Abstract
BACKGROUND: Functional assessment of the right ventricle using real-time three-dimensional echocardiography (RT3DE) has fundamental relevance in young patients with congenital heart disease. Reference values for the pediatric population are scarce. This multicenter study was designed to (1) validate new evaluation software for RT3DE and (2) establish pediatric reference values. METHODS: For validation, right ventricular (RV) end-diastolic volume (EDV) and end-systolic volume (ESV) were determined from real-time three-dimensional echocardiographic data sets of 38 subjects (n = 17 healthy individuals and n = 21 patients with congenital heart disease) using new dedicated evaluation software (RV-Function 2.0) and compared with cardiac magnetic resonance investigations of the same patient cohort. In a prospective multicenter design, 360 real-time three-dimensional echocardiographic data sets of healthy children (172 girls) were analyzed. To create reference centiles, the cohort was subdivided into group I (children <7 years of age, n = 136 [female and male]), group II (girls 7-18 years of age, n = 106), and group III (boys 7-18 years of age, n = 118). RESULTS: Using RT3DE, RV volumes were slightly higher than using cardiac magnetic resonance (EDV, 0.8 ± 5.8% [limits of agreement, -10.8% to 12.5%; r = 0.993]; ESV, 2.0 ± 13.1% [limits of agreement, -24.2% to 28.2%; r = 0.989). Reproducibility was promising (intraobserver variability, 3.9 ± 11.4% for EDV and -1.7 ± 13.4% for ESV [intraclass correlation coefficient range, 0.94-0.98]; interobserver variability, 1.9 ± 11.8% for EDV and -0.3 ± 22.8% for ESV [intraclass correlation coefficient range, 0.85-0.96]). Regarding functional parameters, no significant gender differences were found among children in group I. In contrast, children in groups II and III differed in RV volumes, dimensional parameters, and tricuspid annular plane systolic excursion (P < .005); the children did not differ in deformation parameters. Feasibility was 90%. CONCLUSIONS: RT3DE yields accurate and reproducible RV volumes. The calculated percentile curves may facilitate the clinical use of RT3DE to analyze RV function in children.
BACKGROUND: Functional assessment of the right ventricle using real-time three-dimensional echocardiography (RT3DE) has fundamental relevance in young patients with congenital heart disease. Reference values for the pediatric population are scarce. This multicenter study was designed to (1) validate new evaluation software for RT3DE and (2) establish pediatric reference values. METHODS: For validation, right ventricular (RV) end-diastolic volume (EDV) and end-systolic volume (ESV) were determined from real-time three-dimensional echocardiographic data sets of 38 subjects (n = 17 healthy individuals and n = 21 patients with congenital heart disease) using new dedicated evaluation software (RV-Function 2.0) and compared with cardiac magnetic resonance investigations of the same patient cohort. In a prospective multicenter design, 360 real-time three-dimensional echocardiographic data sets of healthy children (172 girls) were analyzed. To create reference centiles, the cohort was subdivided into group I (children <7 years of age, n = 136 [female and male]), group II (girls 7-18 years of age, n = 106), and group III (boys 7-18 years of age, n = 118). RESULTS: Using RT3DE, RV volumes were slightly higher than using cardiac magnetic resonance (EDV, 0.8 ± 5.8% [limits of agreement, -10.8% to 12.5%; r = 0.993]; ESV, 2.0 ± 13.1% [limits of agreement, -24.2% to 28.2%; r = 0.989). Reproducibility was promising (intraobserver variability, 3.9 ± 11.4% for EDV and -1.7 ± 13.4% for ESV [intraclass correlation coefficient range, 0.94-0.98]; interobserver variability, 1.9 ± 11.8% for EDV and -0.3 ± 22.8% for ESV [intraclass correlation coefficient range, 0.85-0.96]). Regarding functional parameters, no significant gender differences were found among children in group I. In contrast, children in groups II and III differed in RV volumes, dimensional parameters, and tricuspid annular plane systolic excursion (P < .005); the children did not differ in deformation parameters. Feasibility was 90%. CONCLUSIONS: RT3DE yields accurate and reproducible RV volumes. The calculated percentile curves may facilitate the clinical use of RT3DE to analyze RV function in children.
Authors: Ulrike Herberg; Florentina Smit; Christian Winkler; Robert Dalla-Pozza; Johannes Breuer; Kai Thorsten Laser Journal: Quant Imaging Med Surg Date: 2021-07