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Volumetric analysis of the right ventricle in children with congenital heart defects: comparison of biplane angiography and transthoracic 3-dimensional echocardiography

Published online by Cambridge University Press:  19 August 2008

A. Heusch*
Affiliation:
Department of Paediatric Cardiology, Heinrich-Heine-University, Düsseldorf, Germany
J. Rübo
Affiliation:
Department of Paediatric Cardiology, Heinrich-Heine-University, Düsseldorf, Germany
O. N. Krogmann
Affiliation:
Department of Paediatric Cardiology, Heinrich-Heine-University, Düsseldorf, Germany
M. Bourgeois
Affiliation:
Department of Paediatric Cardiology, Heinrich-Heine-University, Düsseldorf, Germany
*
Andreas Heusch, M.D., Dept. of Paediatric Cardiology, Heinrich-Heine-University, Moorenstr. 5, D-40001 Düsseldorf, PB: 101007, Germany. Tel: 0049–211–8117713; Fax: 0049–211–8116287

Abstract

Background

Three-dimensional echocardiography is a non-invasive imaging technique. The fact that it permits volumetric analyses independently of geometrical assumptions makes it a putatively useful method for the precise measurement of the volumes of the irregularly shaped right ventricles in children. The aim of this study was to assess the feasibility of this method and its agreement with angiocardiography based estimates of right ventricular volume in children with congenital heart disease.

Methods

We studied 102 children with congenital heart disease. The angiocardiographic right ventricular volumetry was performed using a biplanar technique using Simpson's rule and corrected with Lange's correction factors. The echo data sets were registered trans-thoracically with a rotating transmitter. Volumes were calculated after manual planimetry by adding the volumes of the individual slices.

Results

Calculation of right ventricular volume echocardiographically was possible only in 34% of patients, mostly infants and toddlers. In comparison to angiocardiography, the measured volumes were 1.1 ±6.9 ml (19.5 ±34.1%) or 6.3±9.4ml (42.5±33.6%) smaller during systole or diastole, respectively. The limits of agreement were −12.5 and 13.6ml, or 12.45 and 25.15ml during systole or diastole, respectively. When plotted to a logarithmical scale, the correlation coefficients r2 were 0.70 for systolic and 0.79 for diastolic measurements.

Conclusion

Transthoracic 3-dimensional echocardiography with a rotating transmitter is feasible for volumetry only in small children. The volumes measured were significantly smaller than the ones calculated from the angiocardiographic images. The correlation between the two methods is moderate.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1999

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References

1.Brodie, B, MC Laurin, L, Grossmann, WCombined hemodynamic ultrasonic method for studying left ventricular wall stress. Am J Cardiol 1976;37: 864867.CrossRefGoogle ScholarPubMed
2.Grossmann, WDiastolic dysfunction in congestive heart failure. N Engl J Med 1991;325: 15571564.Google Scholar
3.Rigolin, V, Robiolio, P, Wilson, J, Harrison, J, Bashore, T. The forgotten chamber: the importance of the right ventricle. Cathet Cardiovasc Diagn 1995;35: 1828.CrossRefGoogle ScholarPubMed
4.Rushmer, R. Cardiovascular Dynamics. Saunders, WB, Philadelphia; 1970.Google Scholar
5.Heusch, A, Koch, J, Krogmann, O, Korbmacher, B, Bourgeois, M. Volumetric analysis of the right and left ventricle in a porcine heart model: Comparison of 3-dimensional echocardiography, magnetic resonance imaging and angiocardiography. Eur J Ultrasound 1999; in pressCrossRefGoogle Scholar
6.Colan, S, Borow, K, NcPherson, D, Neuman, A. Left ventricular endsystolic wall stress-velocity of circumferential fiber shortening relation: a load independent index of myocardial contractility. J Am Coll Cardiol 1984;4: 715724.CrossRefGoogle ScholarPubMed
7.Sandier, H, Alderman, E. Determination of left ventricular size and shape. Circulation Res 1974;34: 1CrossRefGoogle Scholar
8.Lange, P, Onnasch, D, Farr, F, Malrczyk, V, Heintzen, P. Analysis of left and right ventricular size and shape, as determined from human casts. Description of the method and its validation. Eur J Cardiol 1978;8: 431448.Google ScholarPubMed
9.Buck, T, Erbel, R. Diagnostik der koronaren Herzkrankheit mittels 3D-Rekonstruktion. Herz 1995;20: 252262.Google Scholar
10.Altman, D, Bland, J. Measurement in medicine: the analysis of method comparison studies. Statistician 1983;32: 307317.CrossRefGoogle Scholar
11.Jiang, L, Siu, S, Handschumacher, M, Guererro, J, de Prada, J, King, M, Picard, M, Weyman, A, Levine, A. Three dimensional echocardiography; In vivo validation of right ventricular volume and function. Circulation 1994;89: 23422350.CrossRefGoogle ScholarPubMed
12.Vogel, M, White, P, Redington, A. In vitro validation of right ventricular volume measurement by three dimensional echocardiography. Br Heart J 1995;74: 460463.CrossRefGoogle ScholarPubMed
13.Yao, J, Cao, Q-L, Masani, N, Delabays, A, Magni, J, Acar, R, Laskari, C, Pandian, N. Three-dimensional echocardiographic estimation of infarct mass based on quantification of dysfunctional left ventricular mass. Circulation 1997;96: 1660—1666.CrossRefGoogle ScholarPubMed
14.Lange, A, Palka, P, Nowicki, A, Olzlewski, R, Anderson, T, Adamus, J, Fox, KA, Sutherland, G. Three-dimensional echocardiographic evaluation of left ventricular volume: comparison of Doppler myocardial imaging and standard gray-scale imaging with cineventriculography-an in vitro and in vivo study. Am Heart J 1998;135: 970979.CrossRefGoogle ScholarPubMed
15.Mogelvang, J, Stubgaard, M, Thomsen, C, Henriksen, O. Evaluation of right ventricular volumes by magnetic resonance imaging. Eur Heart J 1988;9: 529533.CrossRefGoogle ScholarPubMed
16.Niwa, K, Uchishiba, M, Aotsuka, H, Tobita, K, Matsuo, K, Fujiwara, T, Tateno, S, Hamada, H. Measurement of ventricular volumes by cine magnetic resonance imaging in complex congenital heart disease with morphologically abnormal ventricles. Am Heart J 1996;131: 567575.CrossRefGoogle ScholarPubMed
17.Helbing, W, Rebergen, S, Maliepaard, C, Hansen, B, Otenkamp, J, Reiber, J, de Roos, A. Quantification of right ventricular function with magnetic resonance imaging in children with normal hearts and with congenital heart disease. Am Heart J 1995;130: 828837.CrossRefGoogle ScholarPubMed
18.Aebischer, N, Meuli, R, Jeanrenaud, X, Koerfer, J, Kappenberger, L. An echocardiographic and magnetic resonance imaging comparative study of right ventricular volume determination. Int J Card Imaging 1998;14: 271278.CrossRefGoogle ScholarPubMed
19.Buck, T, Hunold, W, Wentz, K, Tkalec, W, Nesser, H, Erbel, R. Tomographic three-dimensional echocardiographic determination of chamber size and systolic function in patients with left ventricular aneurysm. Circulation 1997;96: 42864297.CrossRefGoogle ScholarPubMed
20.Nosir, YF, Stoker, J, Kasprzak, JD, Lequin, MH, Dall'Agata, A, Ten-Gate, FJ, Roelandt, JR. Paraplane analysis from precordial three-dimensional echocardiographic data sets for rapid and accurate quantification of left ventricular volume and function: a comparison with magnetic resonance imaging. Am Heart J 1999;137: 134143.CrossRefGoogle ScholarPubMed
21.Mele, D, Fehske, W, Maehle, J, Cittanti, C, von-Smekal, A, Luderitz, B, Alboni, P, Levine, RA. A simplified, practical echocardiographic approach for 3-dimensional surfacing and quantitation of the left ventricle: clinical application in patients with abnormally shaped hearts. J Am Soc Echocardiogr. 1998;11: 10011012.CrossRefGoogle ScholarPubMed
22.Vogel, M, Gutberlet, N, Dittrich, M, Hosten, N, Lange, PComparison of trnsthoracic three dimensional echocardiography with magnetic resonance imaging in the agreement of right ventricular volume and mass. Heart 1997;78: 127130.CrossRefGoogle Scholar
23.Papavassiliou, D, Parks, W, Hopkins, K, Fyfe, D. Three-dimensional echocardiographic measurement of right ventricular volume in children with congenital heart disease validated by magnetic resonance imaging. J Am Soc Echcardiogr. 1998;11: 770777.CrossRefGoogle ScholarPubMed
24.Acar, P, Maunoury, C, Antonietti, T, Bonnet, D, Sidi, D, Kachaner, J. Left ventricular ejection fraction in children measured by three-dimensional echocardiography using a new transthoracic integrated 3D-probe. A comparison with equilibrium radionuclide angiography. Eur Heart J 1998;19: 15831588.CrossRefGoogle ScholarPubMed
25.Erbel, R, Krebs, W, Henn, G, Schweitzer, P, Richter, H, Meyer, J, Effert, S. Comparison of single-plane and biplane volume determination by two-dimensional echocardiography. Eur Heart J 1978;3: 469480.CrossRefGoogle Scholar
26.Schiller, N, Aquatella, H, Ports, T. Left ventricular volume from paired biplane two-dimensional echocardiography. Circulation 1997;60: 547555.CrossRefGoogle Scholar
27.Roelandt, J, Salustri, A, Vletter, V, Nosir, Y, Bruining, N. Precordial multiplane echocardiography for dynamic anyplane, paraplane and three dimensional imaging of the heart. Thoraxcencre J 1994;6/1: 48.Google Scholar
28.King, L, Gopal, A, King, D, Shen, Z. Three-dimensional echocardiography: A method for right ventricular volume and endocardial surface area computation in vivo by poly hedral surface reconstruction. J Am Coll Cardiol 1994;23: 333A(Abstract)Google Scholar
29.Shiota, T, Jones, M, Chikada, M, Fleishman, CE, Castellucci, JB, Cotter, B, DeMaria, AN, von-Ramm, OT, Kisslo, J, Ryan, T, Sahn, DJ. Real-time three-dimensional echocardiography for determining right ventricular stroke volume in an animal model of chronic right ventricular volume overload. Circulation 1998;97: 18971900.CrossRefGoogle Scholar
30.Roelandt, J, ten Gate, F, Vletter, V, Taams, A. Ultrasonic dynamic three-dimensional visualization of the heart with a multiplane transoesophageal imaging transducer. J Am Soc Echocardiogr 1994;7: 217229.CrossRefGoogle ScholarPubMed
31.Allan, J, DeJong, S, Smith, R, Kerber, R, McKay, C. Intracardiac echocardiography can quantitatively image the left ventricle from right ventricular transducer position. J Am Coll Cardiol 1997;119AGoogle Scholar
32.Apfel, H, Solowiejczyk, D, Printz, B, Challenger, M, Blood, D, Boxt, L, Barst, L, Gersony, W. Feasibility of a two-dimensional echocardiographic method for the clinical assessment of right ventriculr volume and function in children. J Am Soc Echcardiogr. 1996;9: 637645.CrossRefGoogle Scholar
33.Sapin, P, Schroeder, K, Gopal, A, Smith, M, DeMaria, A, King, D. Comparison of two- and three-dimensional echocardiography with cineventriculography for measurement of left ventricular volume in patients. J Am Coll Cardiol 1994;24: 10541063.CrossRefGoogle ScholarPubMed
34.Siu, S, Levine, A, Rivera, M, Xie, S, Lethor, J, Handschumacher, M, Weyman, A, Picard, M. Three-dimensional echocardiography improves noninvasive assessment of left ventricular volume and performance. Am Heart J 1995;130: 812822.CrossRefGoogle ScholarPubMed
35.Hozumi, T, Yoshikawa, J, Yoshida, K, Akasaka, T, Takagi, T, Yamamuro, A. Three-dimensional echocardiographic measurement of left ventricular volumes and ejection fraction using a multiplane transoesophageal probe in patients. Am J Cardiol 1996;78: 10771080.CrossRefGoogle ScholarPubMed
36.Lee, M-Y, Jiang, L, Handschumacher, M, Guererro, J, Derman, R, Krauss, M, Viahakes, G, Levine, A. Three dimensional voxel imaging of the left ventricle: Is it quantitatively accurate? In vivo validation. Circulation 1994;90: 1337Google Scholar
37.Mele, D, Pratola, C, Pedini, I, Alboni, CR. Validation and application of a new system for three- dimensional echocardio graphic reconstruction of the left ventricle. Circulation 1994;90: 1337Google Scholar
38.Schwartz, S, Cao, Q, Azevedo, J, Pandian, N. Simulation of intraoperative visualization of cardiac structures and study of dynamic surgical anatomy with real-time three-dimensional echocardiography. Am J Cardiol 1994;73: 501507.CrossRefGoogle ScholarPubMed