Aims and objectives
Right ventricular (RV) ejection fraction (RVEF) is an important predictor of cardiovascular morbidity and mortality in various cardiac conditions.
Cardiac MR assessment is the gold standard but time consuming and the complex anatomy makes for a challenging task.
We hypothesized that RV tissue tracking may help identify significantly reduced RVEF.
We will compare tissue tracking with other well-established methods for rapid RV assessment including subjective assessment by cardiac radiologists.
Methods and materials
161 patients with different kinds of diseases were recruited from two centres and from three different scanners (1.5T & 3.0T).
Inclusion criteria were patients undergoing cardiac MR.
Exclusion criteria were poor image quality and severe valvular regurgitation.
RVEF was assessed from short axis cine sequences with contouring the RV endocardial wall (Fig.1).
TAPSE (Fig 2),
RV fractional shortening (RVFS) which is the TAPSE indexed to the ED RV length,
RV fractional area change (RVFAC) (Fig.3)...
RVFS provided the highest diagnostic performance for discrimination of patients with or without RVEF <45% (AUC=0.93).
RV longitudinal and radial strain provided high accuracy for assessment of RVEF<45% (AUC 0.81 and 0.83 respectively).
Cardiac radiologist assessment,
TAPSE and RV FAC showed high accuracy (AUC 0.88,
0.87 and 0.91 respectively).
Other analyses are listed in table 1.
RVFS showed the highest accuracy with RVFS and radiologist assessment having the next highest accuracy.
these rapid assessment techniques do not appear to provide significant improvement in diagnostic accuracy compared to a radiologist's subjective assessment.
Department of Radiology,
The University of Hongkong-Shenzhen Hospital,
China. Email: firstname.lastname@example.org
"The prognostic value of right ventricular long axis strain in non-ischaemic dilated cardiomyopathies using standard cardiac magnetic resonance imaging." Eur Radiol 27 (9): 3913-3923. Drake,
"Right ventricular function assessment: comparison of geometric and visual method to short-axis slice summation method." Echocardiography 24 (10): 1013-1019. Masateru,
“Evaluation of ventricular dysfunction using semi-automatic longitudinal...