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Updated: Aug 11, 2026
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Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Agreement Between Standard and Right Ventricular-Focused Apical Four-Chamber Views for Right Ventricular Longitudinal
Fei-Yi Sun1,2, Ti Zhao1, Jia-Qi Shen1
1Health Management Center, Central Hospital of Dalian University of Technology, Dalian, China.
Echocardiography (Mount Kisco, N.Y.)
|August 10, 2026
Summary
Standard and RV-focused echocardiography views yield similar group results but poor individual agreement for right ventricular function. Consistent view selection is crucial for serial assessments and research data integrity.
Area of Science:
- Cardiology
- Echocardiography
- Cardiac Imaging
Background:
- Right ventricular (RV) function is critical for assessing various cardiovascular conditions.
- Standard and RV-focused apical four-chamber (A4C) views are utilized in echocardiography.
- Understanding the interchangeability of these views is essential for accurate RV assessment.
Purpose of the Study:
- To evaluate the agreement between standard and RV-focused A4C views for measuring RV longitudinal functional indices.
- To determine if measurements of tricuspid annular plane systolic excursion (TAPSE) and other indices are interchangeable at the individual level.
Main Methods:
- A cross-sectional agreement analysis of echocardiographic data from 115 adults was performed.
- Measurements included TAPSE, lateral tricuspid annular velocities (S', e', a'), and tissue motion annular displacement (TMAD) indices.
- Observer reproducibility was assessed in a subset of 30 cases.
Main Results:
- Group-level measurements showed no significant difference between standard and RV-focused views (e.g., TAPSE mean difference -0.09 mm).
- Individual agreement was poor to moderate, with intraclass correlation coefficients (ICCs) ranging from 0.39 to 0.68.
- Sensitivity analyses confirmed poor to moderate ICCs, while observer reproducibility was high (ICCs 0.94-1.00).
Conclusions:
- While group means are similar, standard and RV-focused A4C views lack individual agreement for RV longitudinal function.
- Consistent use and documentation of the echocardiographic acquisition view are recommended for serial evaluations and research.
- Clinicians and researchers should be aware of the limitations when comparing data acquired from different views.
