Echocardiographic Knowledge-Based Reconstruction for Quantification of the Systemic Right Ventricle in Young Adults With Repaired D-Transposition of Great Arteries
- 作者：Shelby Kutty ; MD ; skutty@unmc.edu ; Ling Li ; MD ; PhD ; Amanda Polak ; RDCS ; Paul Gribben ; BS ; David A. Danford ; MD
- 刊名：The American Journal of Cardiology
- 出版年：2012
- 期刊代码：5_00029149
- 类别：med
- 出版时间：15 March, 2012
- 卷：109
- 期：6
- 页码：881-888
- 文件大小：2189 K
摘要
The systemic right ventricle (RV) in congenital heart disease is susceptible to progressive dilation and dysfunction. A 2-dimensional echocardiographic means for serial monitoring of the RV would be of great value in this clinical setting. We used 2-dimensional echocardiography with knowledge-based reconstruction (2DE-KBR) for evaluation of systemic RV. Patients with d-transposition of great arteries repaired with an atrial switch and without implanted pacemakers were prospectively recruited for same-day 2DE-KBR and cardiac magnetic resonance (CMR) imaging. RV images were acquired in various 2-dimensional imaging planes using a 3-dimensional space-localizing device attached to the imaging transducer and 3-dimensional reconstruction was performed. RV end-diastolic volume, end-systolic volume, and ejection fraction (EF) were calculated and compared to volumetric CMR analysis. Fifteen patients (7 women, 8 men, 24 卤 7 years old, weight 67 卤 12 kg) were studied. There was good agreement of 2DE-KBR and CMR measurements. Mean RV end-diastolic volume was 221 卤 39 ml with 2DE-KBR and 231 卤 35 ml with CMR (r = 0.80); mean end-systolic volume was 129 卤 35 ml with KBR and 132 卤 30 ml with CMR (r = 0.82), and EF was 42 卤 10%with KBR and 43 卤 7%with CMR (r = 0.86). For 2DE-KBR mean interobserver variabilities were 4.6%, 2.6%, and 4.3%; intraobserver variabilities were 3.2%, 3.1%, and 2.3%, respectively, for end-diastolic volume, end-systolic volume, and EF. In conclusion, this study demonstrates the clinical feasibility of quantifying systemic RV volumes and function using 2DE-KBR in adolescents and young adults with repaired d-transposition of great arteries and good agreement of measurements with CMR.