Abstract
Background
Assessment of right ventricular (RV) systolic function is not an easy task. Although RV fractional area change (FAC) and tricuspid annular plane systolic excursion (TAPSE) are useful in the assessment of RV function, their use can be sometimes limited. Right ventricular outflow tract systolic excursion (RVOT_SE) is a new way to evaluate RV systolic function. The aim of this study was to assess the correlation between RVOT_SE and other RV systolic function assessment methods.
Methods
RVOT_SE was defined as the systolic excursion of the RV outflow tract anterior wall endocardium. A total of 104 patients with a wide range of RV systolic function, ejection fraction, and pulmonary artery systolic pressure were studied. We also measured another four ways to evaluate RV systolic function, FAC, TAPSE, right ventricular outflow tract fractional shortening (RVOT_FS), and tricuspid annular systolic excursion velocity S′ (Tissue S′).
Results
There was a strong correlation between RVOT_SE and each one of the four studied ways to evaluate RV systolic function. Multivariate regression analysis showed that the independent variables correlated with RVOT_SE were RVOT_FS (p < 0.0001), FAC (p = 0.005) and TAPSE (p = 0.023). RVOT_SE diagnosed patients with reduced RV systolic function with 98 % sensitivity and 96 % specificity. There was no correlation between RVOT_SE and ejection fraction, or between RVOT_SE and pulmonary artery systolic pressure in patients with reduced RV systolic function. Intra-observer and inter-observer reproducibility were favorable for RVOT_SE and all four studied ways.
Conclusions
RVOT_SE is a simple, accurate, and promising method for evaluating RV systolic function.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Jurcut R, Giusca S, La Gerche A, et al. The echocardiographic assessment of the right ventricle: what to do in 2010? Eur J Echocardiogr. 2010;11(2):81–96.
Giovanardi P, Stefanelli G, Turrini F, et al. Interactions between commonly used left and right ventricular function indexes in stable patients. Minerva Cardioangiol. 2014;62(4):335–41.
Kim YJ, Kwon DA, Kim HK, et al. Determinants of surgical outcome in patients with isolated tricuspid regurgitation. Circulation. 2009;120(17):1672–8.
Dini FL, Conti U, Fontanive P, et al. Right ventricular dysfunction is a major predictor of outcome in patients with moderate to severe mitral regurgitation and left ventricular dysfunction. Am Heart J. 2007;154(1):172–9.
Nagel E, Stuber M, Hess OM. Importance of the right ventricle in valvular heart disease. Eur Heart J. 1996;17(6):829–36.
Giovanardi P, Tincani E, Rossi R, et al. Right ventricular function predicts cardiovascular events in outpatients with stable cardiovascular diseases: preliminary results. Intern Emerg Med. 2012;7(3):251–6.
Damy T, Viallet C, Lairez O, et al. Comparison of four right ventricular systolic echocardiographic parameters to predict adverse outcomes in chronic heart failure. Eur J Heart Fail. 2009;11(9):818–24.
Vizza CD, Lynch JP, Ochoa LL, et al. Right and left ventricular dysfunction in patients with severe pulmonary disease. Chest. 1998;113(3):576–83.
van Straten A, Vliegen HW, Hazekamp MG, et al. Right ventricular function after pulmonary valve replacement in patients with tetralogy of Fallot. Radiology. 2004;233(3):824–9.
Asmer I, Adawi S, Ganaeem M, et al. Right ventricular outflow tract systolic excursion: a novel echocardiographic parameter of right ventricular function. Eur Heart J Cardiovasc Imaging. 2012;13(10):871–7.
John R, Lee S, Eckman P, et al. Right ventricular failure—a continuing problem in patients with left ventricular assist device support. J Cardiovasc Transl Res. 2010;3(6):604–11.
Evangelista A, Flachskampf F, Lancellotti P, et al. European Association of Echocardiography recommendations for standardization of performance, digital storage and reporting of echocardiographic studies. Eur J Echocardiogr. 2008;9(4):438–48.
Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685.
Geva T, Powell AJ, Crawford EC, et al. Evaluation of regional differences in right ventricular systolic function by acoustic quantification echocardiography and cine magnetic resonance imaging. Circulation. 1998;98(4):339–45.
Aune E, Baekkevar M, Rodevand O, et al. The limited usefulness of real-time 3-dimensional echocardiography in obtaining normal reference ranges for right ventricular volumes. Cardiovasc Ultrasound. 2009;7:35.
Lindqvist P, Henein M, Kazzam E. Right ventricular outflow-tract fractional shortening: an applicable measure of right ventricular systolic function. Eur J Echocardiogr. 2003;4(1):29–35.
Kutty S, Zhou J, Gauvreau K, et al. Regional dysfunction of the right ventricular outflow tract reduces the accuracy of Doppler tissue imaging assessment of global right ventricular systolic function in patients with repaired tetralogy of Fallot. J Am Soc Echocardiogr. 2011;24(6):637–43.
Greutmann M, Tobler D, Biaggi P, et al. Echocardiography for assessment of regional and global right ventricular systolic function in adults with repaired tetralogy of Fallot. Int J Cardiol. 2012;157(1):53–8.
Anavekar NS, Gerson D, Skali H, et al. Two-dimensional assessment of right ventricular function: an echocardiographic-MRI correlative study. Echocardiography. 2007;24(5):452–6.
Kaul S, Tei C, Hopkins JM, et al. Assessment of right ventricular function using two-dimensional echocardiography. Am Heart J. 1984;107(3):526–31.
Beigel R, Cercek B, Luo H, et al. Noninvasive evaluation of right atrial pressure. J Am Soc Echocardiogr. 2013;26(9):1033–1042.
Conflict of interest
Farhood Alsoos, Mohammad Almobarak, and Hussam shebli declare that they have no conflicts of interest, including any financial relationships with industrial echocardiograph companies or lecture fees.
Human rights statements and informed consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Alsoos, F., Almobarak, M. & Shebli, H. Right ventricular outflow tract systolic excursion: a useful method for determining right ventricular systolic function. J Echocardiogr 12, 151–158 (2014). https://doi.org/10.1007/s12574-014-0229-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12574-014-0229-x