1
|
Ahmad A, Shigemitsu S, Termachi Y, Windram J, Khoo N, Colen T, Eckersley L. Comparing a knowledge-based 3D reconstruction algorithm to TomTec 3D echocardiogram algorithm in measuring left cardiac chamber volumes in the pediatric population. Echocardiography 2022; 39:1180-1189. [PMID: 36029116 DOI: 10.1111/echo.15427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/16/2022] [Accepted: 07/01/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Three-dimensional echocardiography (3DE) is an emerging method for volumetric cardiac measurements; however, few vendor-neutral analysis packages exist. Ventripoint Medical System Plus (VMS3.0+) proprietary software utilizes a validated Magnetic resonance imaging (MRI) database of normal ventricular and atrial morphologies to calculate chamber volumes. This study aimed to compare left ventricular (LV) and atrial (LA) volumes obtained using VMS3.0+ to Tomtec echocardiography analysis software. METHODS Healthy controls (n = 98) aged 0-18 years were prospectively recruited and 3D DICOM datasets focused on the LV and LA acquired. LV and LA volumes and ejection fractions were measured using TomTec Image Arena 3D LV analysis package and using VMS3.0+. Pearson correlation coefficients, Bland-Altman's plots, and intraclass coefficients (ICC) were calculated, along with analysis time. RESULTS There was a very good correlation between Ventripoint Medical System (VMS) and Tomtec LV systolic (r2 = .88, ICC .89 [95% CI .81, .94]), and diastolic (r2 = .88, ICC .90 [95% CI .77, .95]) volumes, and between VMS and Tomtec LA diastolic (r2 = .75, ICC .89 [95% CI .81, .93]) and systolic (r2 = .88, ICC .91 [95% CI .78, .96]) volumes on linear regression models. Natural log transformations eliminated heteroscedasticity, and power transformations provided the best fit. The time (mins) to analyze volumes using VMS were less than using Tomtec (LV VMS 2.3 ± .5, Tomtec 3.3 ± .8, p < .001; LA: VMS 1.9 ± .4, Tomtec 3.4 ± 1.0, p < .001). CONCLUSIONS There was a very good correlation between knowledge-based (VMS3.0+) and 3D (Tomtec) algorithms when measuring 3D echocardiography-derived LA and LV volumes in pediatric patients. VMS was slightly faster than Tomtec in analyzing volumetric measurements.
Collapse
Affiliation(s)
- Attila Ahmad
- Division of Cardiology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Division of Cardiology, Department of Medicine, Mazankowski Heart Institute, Edmonton, Alberta, Canada
| | - Sachie Shigemitsu
- Division of Cardiology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Yozo Termachi
- Division of Cardiology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Jonathan Windram
- Division of Cardiology, Department of Medicine, Mazankowski Heart Institute, Edmonton, Alberta, Canada
| | - Nee Khoo
- Division of Cardiology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Division of Cardiology, Department of Medicine, Mazankowski Heart Institute, Edmonton, Alberta, Canada
| | - Tim Colen
- Division of Cardiology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Division of Cardiology, Department of Medicine, Mazankowski Heart Institute, Edmonton, Alberta, Canada
| | - Luke Eckersley
- Division of Cardiology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Division of Cardiology, Department of Medicine, Mazankowski Heart Institute, Edmonton, Alberta, Canada
| |
Collapse
|
2
|
Mathijssen H, Huitema MP, Bakker ALM, Akdim F, van Es HW, Grutters JC, Post MC. Value of echocardiography using knowledge-based reconstruction in determining right ventricular volumes in pulmonary sarcoidosis: comparison with cardiac magnetic resonance imaging. Int J Cardiovasc Imaging 2021; 38:309-316. [PMID: 34586530 DOI: 10.1007/s10554-021-02405-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
Right ventricular (RV) dysfunction in sarcoidosis is associated with adverse outcomes. Assessment of RV function by conventional transthoracic echocardiography (TTE) is challenging due to the complex RV geometry. Knowledge-based reconstruction (KBR) combines TTE measurements with three-dimensional coordinates to determine RV volumes. The aim of this study was to investigate the accuracy of TTE-KBR compared to the gold standard cardiac magnetic resonance imaging (CMR) in determining RV dimensions in pulmonary sarcoidosis. Pulmonary sarcoidosis patients prospectively received same-day TTE and TTE-KBR. If performed, CMR within 90 days after TTE-KBR was used as reference standard. Outcome parameters included RV end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (RVSV) and ejection fraction (RVEF). 281 patients underwent same day TTE and TTE-KBR. In total, 122 patients received a CMR within 90 days of TTE and were included. TTE-KBR measured RVEDV and RVESV showed strong correlation with CMR measurements (R = 0.73, R = 0.76), while RVSV and RVEF correlated weakly (R = 0.46, R = 0.46). Bland-Altman analyses (mean bias ± 95% limits of agreement), showed good agreement for RVEDV (ΔRVEDVKBR-CMR, 5.67 ± 55.4 mL), while RVESV, RVSV and RVEF showed poor agreement (ΔRVESVKBR-CMR, 21.6 ± 34.1 mL; ΔRVSVKBR-CMR, - 16.1 ± 42.9 mL; ΔRVEFKBR-CMR, - 12.9 ± 16.4%). The image quality and time between CMR and TTE-KBR showed no impact on intermodality differences and there was no sign of a possible learning curve. TTE-KBR is convenient and shows good agreement with CMR for RVEDV. However, there is poor agreement for RVESV, RVSV and RVEF. The use of TTE-KBR does not seem to provide additional value in the determination of RV dimensions in pulmonary sarcoidosis patients.
Collapse
Affiliation(s)
- Harold Mathijssen
- Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
| | - Marloes P Huitema
- Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands
| | - Annelies L M Bakker
- Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands
| | - Fatima Akdim
- Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands
| | - Hendrik W van Es
- Department of Radiology, St. Antonius Hospital Nieuwegein/Utrecht, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands
| | - Jan C Grutters
- Department of Pulmonology, St. Antonius Hospital Nieuwegein/Utrecht, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.,Department of Pulmonology, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Marco C Post
- Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.,Department of Cardiology, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| |
Collapse
|
4
|
Chowdhury SM, Hijazi ZM, Fahey JT, Rhodes JF, Kar S, Makkar R, Mullen M, Cao QL, Shirali GS. Speckle-Tracking Echocardiographic Measures of Right Ventricular Function Correlate With Improvement in Exercise Function After Percutaneous Pulmonary Valve Implantation. J Am Soc Echocardiogr 2015; 28:1036-44. [PMID: 26117295 DOI: 10.1016/j.echo.2015.05.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Indexed: 10/23/2022]
Abstract
BACKGROUND Speckle-tracking echocardiographic (STE) measures of right ventricular (RV) function appear to improve after transcatheter pulmonary valve implantation (TPVI). Measures of exercise function, such as ventilatory efficiency (the minute ventilation [VE]/carbon dioxide production [VCO2] slope), have been shown to be prognostic of mortality in patients who may require TPVI. The aim of this study was to evaluate the correlation between STE measures of RV function and changes in VE/VCO2 after TPVI. METHODS Speckle-tracking echocardiography and cardiopulmonary exercise testing were performed at baseline and 6 months after TPVI in 24 patients from four centers. Conventional echocardiographic measures of RV function were also assessed. Echocardiographic and exercise stress test results were interpreted by single blinded observers at separate core laboratories. RESULTS All patients demonstrated relief of pulmonary regurgitation and stenosis after TPVI. Improvements in RV longitudinal strain (-16.9 ± 3.5% vs -19.7 ± 4.3%, P < .01) and strain rate (-0.9 ± 0.4 vs. -1.2 ± 0.4 s(-1), P < .01) were noted. The VE/VCO2 slope improved (32.4 ± 5.7 vs 31.5 ± 8.8, P = .03). No other significant echocardiographic or exercise changes were found. On multivariate regression, the change in VE/VCO2 was independently associated with change in RV longitudinal early diastolic strain rate (P < .001) and tricuspid A velocity (P < .001). Preintervention RV longitudinal strain was found to be a predictor of change in VE/VCO2 after TPVI (r = -0.60, P < .001). CONCLUSIONS STE measures of RV function appear to hold the potential for use as predictors of improved outcomes in patients requiring TPVI. Future studies should directly assess the prognostic significance of STE measures of RV function in this population.
Collapse
Affiliation(s)
- Shahryar M Chowdhury
- Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina.
| | - Ziyad M Hijazi
- Department of Pediatrics, Sidra Medical and Research Center, Doha, Qatar
| | - John T Fahey
- Department of Pediatrics, Yale-New Haven Hospital, New Haven, Connecticut
| | - John F Rhodes
- Department of Pediatrics, Miami Children's Hospital, Miami, Florida
| | - Saibal Kar
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Raj Makkar
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Michael Mullen
- Department of Medicine, The Heart Hospital, London, United Kingdom
| | - Qi-Ling Cao
- Rush Center for Congenital & Structural Heart Disease, Rush University Medical Center, Chicago, Illinois
| | - Girish S Shirali
- The Ward Family Heart Center, Children's Mercy Hospital, Kansas City, Missouri
| |
Collapse
|