Echocardiographic assessment of right ventricular function: current clinical practice

Area of Science:

• Cardiology
• Medical Imaging
• Echocardiography

Background:

• Assessing right ventricular (RV) function is complex due to its intricate anatomy.
• Transthoracic echocardiography offers methods for RV function quantification, but many are time-consuming or require specialized equipment.
• The clinical adoption of established RV function markers is uncertain.

Purpose of the Study:

• To evaluate the current clinical practice standards for quantifying RV function using echocardiography.
• To identify which echocardiographic parameters for RV function assessment are widely used globally.

Main Methods:

• A multinational online survey was conducted among echocardiographers.
• Participants were recruited via an Ultrasound Online Teaching Platform network.
• The survey assessed the use of various RV function parameters: eyeballing, TAPSE, S', fractional area change, RIMP, 3D-EF, dp/dt, and longitudinal strain.

Main Results:

• 1150 participants from 109 countries completed the survey.
• Eyeballing (72%), TAPSE (69%), and S' (31%) were the most frequently used methods in clinical routine.
• Methods were used less in low-income economies compared to high-income economies.
• Only 23% relied solely on eyeballing for RV function assessment.
• Advanced techniques like global longitudinal strain (3%) and 3D echocardiography (1%) were rarely used, irrespective of region or economic status.

Conclusions:

• Eyeballing and TAPSE remain the predominant echocardiographic methods for assessing RV function.
• Despite proven accuracy, advanced parameters such as longitudinal strain and 3D echocardiography are infrequently implemented in routine clinical practice.
• Disparities in method utilization exist between high-income and low-income economies.