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Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Assessment of biatrial function in clinically well pediatric bicaval heart transplantation patients by
Meng Li1,2, Qing Lv1,2, Shuyuan Wang1,2
1Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China.
Insights
Three-dimensional echocardiography (3DE) reveals enlarged atrial sizes and impaired atrial function in pediatric heart transplant (HTx) patients. These findings highlight 3DE
Area of Science:
- Cardiology
- Pediatric Cardiology
- Echocardiography
Background:
- Atrial size and function are critical for cardiovascular performance.
- Assessing atrial contributions is vital in pediatric heart transplantation (HTx) patients.
Purpose of the Study:
- To evaluate atrial size and function in pediatric HTx patients using three-dimensional echocardiography (3DE).
- To compare 3DE findings with traditional two-dimensional echocardiography (2DE) in this population.
Main Methods:
- Enrolled 33 pediatric HTx patients and 33 healthy controls.
- Utilized both 2DE and 3DE to assess biatrial parameters.
- Measured maximal volume, minimal volume, ejection volume, and ejection fraction for both atria.
Main Results:
- 3DE showed significantly increased left and right atrial volumes (Vmax, Vmin, VpreA) in HTx patients.
- 3DE indicated significantly decreased atrial function (ejection fraction, passive ejection fraction) in HTx patients.
- Significant discrepancies were observed between 3DE and 2DE parameters, with 3DE confirming enlarged atria and reduced function.
Conclusions:
- 3DE provides a more comprehensive assessment of atrial size and function in pediatric HTx patients.
- Pediatric HTx patients exhibit significantly enlarged atria and impaired atrial function compared to controls.
- 3DE findings underscore the need for advanced imaging in managing pediatric heart transplant recipients.
Abstract:
Atrial size and function are closely correlated with atrial contributions to cardiovascular performance. Therefore, in this study, we aimed to assess atrial size and function in pediatric heart transplantation (HTx) patients using three-dimensional echocardiography (3DE). We enrolled 33 clinically well pediatric HTx patients and 33 healthy controls with a similar distribution of sex and age to the HTx patients. All patients underwent two-dimensional echocardiography (2DE) and 3DE. 2DE- and 3DE-derived biatrial maximal volume (Vmax), minimal volume (Vmin), ejection volume (EV), ejection fraction (EF), volume before atrial contraciton (VpreA), passive EV, passive EF, active EV and active EF were obtained in all patients. The 3D left atrail (LA) Vmax, Vmin and VpreA increased significantly in HTx patients after being indexed by BSA, while 3D LAEV and passive EV decreased significantly (P < 0.05). Moreover, the 3D LAEF, LA passive EF, and LA active EF all decreased significantly in HTx patients (P < 0.05). The 3D right atrial (RA) Vmax, Vmin, and VpreA increased significantly in HTx patients (P < 0.05), while the 3D RAEF and RA passive EF decreased significantly in HTx patients (P < 0.05). 3DE-derived LAVmax, LAVpreA, LA passive EV, LAEF, and LA passive EF were all lower than the corresponding 2D parameters. 3DE-derived RAVpreA, RA passive EV and RAEF were all lower than the corresponding 2D parameters. Atrial sizes and function assessed by 3DE- and 2DE-derived parameters, yield significantly discordant results in pediatric HTx patients. 3DE confirms significantly enlarged atrial sizes and decreased atrial functions in pediatric HTx patients.
