Comparison of Echocardiographic parameters with Cardiac Magnetic
Resonance Imaging in the Assessment of Right Ventricular Function
Introduction: The right ventricle (RV) strain measured by speckle
tracking (RVS) is a novel method of assessing RV function. We compared
RVS to RV fractional area change (FAC%), tricuspid annular peak
systolic excursion (TAPSE) and Doppler tissue imaging-derived peak
systolic velocity (S’) in the assessment of right ventricular (RV)
systolic function measured using cardiac magnetic resonance imaging
(MRI). Methods: We enrolled consecutive patients who underwent cardiac
MRI between Jan 2012- Dec 2017 and a transthoracic echocardiogram (TTE)
within 1 month of the MRI with no interval event. Baseline clinical
characteristics and MRI parameters were extracted from chart review.
Echocardiographic parameters were measured prospectively. TTE parameters
including RVS, TAPSE, S’ and FAC% were tested for accuracy to identify
impaired RV EF (EF <45% & <30%) using receiver
operator curves. Results: The study cohort included 500 patients with
mean age 55 yr ± 18 and right ventricular systolic pressure 33.7 ± 13.6
mmHg. The area under ROC for RVS was 0.69 (95% CI 0.63 – 0.75) and
0.78 (95% CI 0.70 – 0.88) to predict RVEF <45% & RVEF
<30% respectively. The RV FAC % had second highest accuracy
of predicting RVEF among all the TTE parameters tested in study.
Conclusion: Right ventricular strain is the most accurate
echocardiographic method to detect impaired right ventricular systolic
function when using MRI as the gold standard.