Validation and Reference Values for Three-Dimensional Echocardiographic Right Ventricular Volumetry in Children:...

Area of Science:

• Cardiology
• Pediatric Cardiology
• Medical Imaging

Background:

• Functional assessment of the right ventricle (RV) is crucial for pediatric congenital heart disease.
• Limited reference values exist for pediatric RV assessment using real-time three-dimensional echocardiography (RT3DE).
• This study aimed to validate RT3DE software and establish pediatric reference values.

Purpose of the Study:

• Validate new evaluation software (RV-Function 2.0) for RT3DE.
• Establish pediatric reference values for RV functional parameters.
• Improve clinical assessment of RV function in children with congenital heart disease.

Main Methods:

• Validated RV end-diastolic volume (EDV) and end-systolic volume (ESV) using RT3DE against cardiac magnetic resonance in 38 subjects.
• Analyzed 360 RT3DE datasets from healthy children, stratified by age and sex.
• Subdivided cohorts into group I (<7 years), group II (girls 7-18 years), and group III (boys 7-18 years).

Main Results:

• RT3DE showed slightly higher RV volumes than cardiac magnetic resonance (EDV: 0.8 ± 5.8%, ESV: 2.0 ± 13.1%).
• Demonstrated promising reproducibility for intraobserver (ICC 0.94-0.98) and interobserver (ICC 0.85-0.96) variability.
• Found significant gender differences in RV volumes and dimensions in older children (groups II and III), but not in deformation parameters. Feasibility was 90%.

Conclusions:

• RT3DE provides accurate and reproducible RV volume measurements in pediatric populations.
• The established percentile curves facilitate the clinical application of RT3DE for evaluating RV function in children.
• This methodology supports improved diagnosis and management of pediatric congenital heart disease.