Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-26T17:00:47.340Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of semi-automated versus manual quantitative right ventricular assessment in tetralogy of Fallot

Part of: Echocardiography Tetralogy of Fallot (TOF)

Published online by Cambridge University Press:  09 March 2021

Joanna Lowisz ,
Francis J. Alenghat ,
Yi Li ,
David Roberson ,
Jamie Penk  and
Rupali Gandhi Open the ORCID record for Rupali Gandhi [Opens in a new window]
Joanna Lowisz
Affiliation:
Department of Pediatric Cardiology, Children’s Hospital Minnesota, Minneapolis, MN, USA
Francis J. Alenghat
Affiliation:
Department of Medicine, Section of Cardiology, University of Chicago, Chicago, IL, USA
Yi Li
Affiliation:
Department of Pediatric Cardiology, Advocate Children’s Hospital, Oak Lawn, IL, USA
David Roberson
Affiliation:
Department of Pediatric Cardiology, Advocate Children’s Hospital, Oak Lawn, IL, USA
Jamie Penk
Affiliation:
Department of Pediatric Cardiology, Lurie Children’s Hospital, ChicagoIL, USA
Rupali Gandhi*
Affiliation:
Department of Pediatric Cardiology, Advocate Children’s Hospital, Oak Lawn, IL, USA
*
Author for correspondence: Rupali Gandhi, MD, JD, Department of Pediatric Cardiology, Advocate Children’s Hospital, Chicago, IL, 4440 W, USA. 95th Street, Oak Lawn, IL, 60453. Phone: 708-684-5580. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Tetralogy of Fallot is a congenital heart defect diagnosed in infancy. Assessment of right ventricular size and function is important for evaluation of patients with tetralogy of Fallot, but these quantitative measures are challenging by echocardiography. This study evaluates a semi-automated software (EchoInsight®, Epsilon Imaging) by comparing its measures to manual measures in children with tetralogy of Fallot.

Methods:

Echocardiographic measurements were performed using manual techniques and semi-automated software. Right ventricular measurements included end-diastolic and end-systolic area, fractional area change, chamber dimensions, and tricuspid annular plane systolic excursion. Reliability, correlation, and agreement between manual and semi-automated measures were assessed.

Results:

Echocardiograms for 46 patients were analysed. Intra- and inter-observer reliabilities for semi-automated measures were good with intraclass correlation coefficients all over 0.95 and 0.85, respectively. There was high correlation between manual and semi-automated methods for areas and dimensions (r = 0.91–0.98). Tricuspid annular plane systolic excursion measures and fractional area change also correlated, albeit less strongly. The semi-automated measurements of end-systolic and end-diastolic area were a 20 and 47% higher than manual methods, respectively.

The semi-automated method yielded a relative 52% lower fractional area change compared to the manual method.

Conclusions:

The semi-automated software generates quantitative right ventricular measures in children with tetralogy of Fallot with good reliability and good correlation with manual methods for all measures, but with significant difference between manual and semi-automated techniques for area and functional measures. The specific right ventricular geometry in tetralogy of Fallot children may be why, compared to normal anatomy, greater differences were observed between the two techniques.

Keywords

Paediatric cardiologytetralogy of Fallotright ventricular measurementsechocardiographyepsilonechoInsightsemi-automated measurementsfractional area change
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 11 , November 2021 , pp. 1781 - 1787
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Lai, WW, Geva, T, Shirali, GS, et al. Guidelines and standards for performance of a pediatric echocardiogram: a report from the task force of the pediatric council of the American Society of Echocardiography. J Am Soc Echocardiogr 2006; 19: 1413–1430. https://doi.org/10.1016/j.echo.2006.09.001 CrossRefGoogle ScholarPubMed
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: 339–345. https://doi.org/10.1161/01.CIR.98.4.339 CrossRefGoogle ScholarPubMed
Oe, M, Gorcsan, J, Mandarino, WA, et al. Automated echocardiographic measures of right ventricular area as an index of volume and end-systolic pressure-area relations to assess right ventricular function. Circulation 1995; 92: 1026–1033. https://doi.org/10.1161/01.CIR.92.4.1026 CrossRefGoogle ScholarPubMed
Kovács, A, Lakatos, B, Tokodi, M, Merkely, B Right ventricular mechanical pattern in health and disease: beyond longitudinal shortening. Heart Fail Rev 2019; 24: 511–520. https://doi.org/10.1007/s10741-019-09778-1 CrossRefGoogle ScholarPubMed
Gatzoulis, MA, Balaji, S, Webber, SA, et al. Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot: a multicentre study. Lancet 2000; 356: 975–981. https://doi.org/10.1016/S0140-6736(00)02714-8 CrossRefGoogle ScholarPubMed
Khairy, P, Aboulhosn, J, Gurvitz, MZ, et al. Arrhythmia burden in adults with surgically repaired tetralogy of Fallot: a multi-institutional study. Circulation 2010; 122: 868–875. https://doi.org/10.1161/CIRCULATIONAHA.109.928481 CrossRefGoogle ScholarPubMed
Knauth, AL, Gauvreau, K, Powell, AJ, et al. Ventricular size and function assessed by cardiac MRI predict major adverse clinical outcomes late after tetralogy of Fallot repair. Heart 2008; 94: 211–216. https://doi.org/10.1136/hrt.2006.104745 CrossRefGoogle ScholarPubMed
Geva, T Indications and timing of pulmonary valve replacement after tetralogy of Fallot repair. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2006; 11–22. https://doi.org/10.1053/j.pcsu.2006.02.009 CrossRefGoogle ScholarPubMed
Therrien, J, Provost, Y, Merchant, N, et al. Optimal timing for pulmonary valve replacement in adults after tetralogy of Fallot repair. Am J Cardiol 2005; 95: 779–782. https://doi.org/10.1016/j.amjcard.2004.11.037 CrossRefGoogle ScholarPubMed
Iriart, X, Montaudon, M, Lafitte, S, et al. Right ventricle three-dimensional echography in corrected tetralogy of Fallot: accuracy and variability. Eur J Echocardiogr 2009; 10: 784–792. https://doi.org/10.1093/ejechocard/jep071 CrossRefGoogle ScholarPubMed
Grothues, F, Moon, JC, Bellenger, NG, et al. Interstudy reproducibility of right ventricular volumes, function, and mass with cardiovascular magnetic resonance. Am Heart J 2004; 147: 218–223. https://doi.org/10.1016/j.ahj.2003.10.005 CrossRefGoogle ScholarPubMed
Geva, T Repaired tetralogy of Fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support. J Cardiovasc Magn Reson 2011; 13: 9. https://doi.org/10.1186/1532-429X-13-9 CrossRefGoogle ScholarPubMed
Koestenberger, M, Friedberg, MK Non-invasive imaging for congenital heart disease: recent innovations in transthoracic echocardiography. J Clin Exp Cardiolog 2012; 01. https://doi.org/10.4172/2155-9880.S8-002 CrossRefGoogle Scholar
Khoo, NS, Young, A, Occleshaw, C, et al. Assessments of right ventricular volume and function using three-dimensional echocardiography in older children and adults with congenital heart disease: comparison with cardiac magnetic resonance imaging. J Am Soc Echocardiogr 2009; 22: 1279–1288. https://doi.org/10.1016/j.echo.2009.08.011 CrossRefGoogle ScholarPubMed
Grewal, J, Majdalany, D, Syed, I, et al. Three-dimensional echocardiographic assessment of right ventricular volume and function in adult patients with congenital heart disease: comparison with magnetic resonance imaging. J Am Soc Echocardiogr 2010; 23: 127–133. https://doi.org/10.1016/j.echo.2009.11.002 CrossRefGoogle ScholarPubMed
Lopez, L, Colan, SD, Frommelt, PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the pediatric measurements writing group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010; 23: 465–495. https://doi.org/10.1016/j.echo.2010.03.019 CrossRefGoogle ScholarPubMed
Medvedofsky, D, Addetia, K, Hamilton, J, et al. Semi-automated echocardiographic quantification of right ventricular size and function. Int J Cardiovasc Imaging 2015; 31: 1149–1157. https://doi.org/10.1007/s10554-015-0672-4 CrossRefGoogle ScholarPubMed
McCloud, AK, Lowisz, J, Roberson, DA, et al. Semi-automated speckle-tracking for quantitative right ventricular assessment in children and adolescents. Cardiol Young 2019; 29: 1149–1159. https://doi.org/10.1017/S1047951119001641 CrossRefGoogle ScholarPubMed
Penk, J, Mukadam, S, Zaidi, SJ, et al. Comparison of semi-automated versus manual quantitative right ventricular assessment in hypoplastic left heart syndrome. Pediatr Cardiol 2019. https://doi.org/10.1007/s00246-019-02223-y Google ScholarPubMed