Right ventricular contraction patterns in healthy children using three-dimensional echocardiography

Area of Science:

• Cardiology
• Pediatric Cardiology
• Medical Imaging

Background:

• The right ventricle (RV) exhibits complex geometry and triaxial motion (longitudinal, radial, anteroposterior), complicating quantitative functional assessment.
• Traditional two-dimensional echocardiography (2DE) has limitations in fully evaluating RV function due to its complexity.
• Three-dimensional (3D) echocardiography offers a more comprehensive approach to assessing RV function contributors.

Purpose of the Study:

• To quantify longitudinal, radial, and anteroposterior components of global RV function in healthy children using 3D echocardiography.
• To investigate maturational changes in these RV function parameters within a pediatric cohort.
• To establish normative data for RV function components in children.

Main Methods:

• Acquired 3D echocardiographic datasets from a cohort of healthy pediatric patients with normal cardiac structures.
• Performed offline analysis to generate RV contours and decompose motion into longitudinal, radial, and anteroposterior components.
• Calculated ejection fractions (LEF, REF, AEF) for each component and indexed them against global RVEF; calculated strain values.

Main Results:

• Analysis included 166 healthy children (median age 13.5 years).
• Anteroposterior ejection fraction (AEF) was significantly greater than radial (REF) and longitudinal (LEF) ejection fractions (p < 0.001).
• Age-related differences were observed in global RV ejection fraction, REF, and all RV strain components.

Conclusions:

• Anteroposterior shortening represents the dominant component of RV contraction in healthy children.
• 3D echocardiographic evaluation of RV parameters in children is feasible and improves understanding of RV function.
• This approach may aid in future recognition of RV dysfunction and assessment of treatment efficacy.