Evaluation of right ventricular function using a novel three-dimensional speckle-tracking echocardiography automatic analysis system.

Background: Right ventricular (RV) dysfunction is an important prognostic predictor of various cardiovascular diseases. However, the complex structural morphology of the RV limits the accurate quantitative assessment of its function. We investigated the utility of a novel three-dimensional speckle-tracking echocardiography (3D-STE) analysis system with automatic tracing and analysis functions to evaluate global and regional RV function.

Methods: This study involved 60 healthy participants; 3D-STE analysis of the RV using 3D RV-STE automatic analysis software was compared with conventional two-dimensional echocardiography findings. We measured the peak global and regional 3D RV area change ratios (3D RV-ACRs). The peak regional 3D RV-ACRs were measured for three inlet, two apical, and two outflow tract segments of the RV; 3D RV ejection fraction (3D-RVEF) was also measured.

Results: The 3D RV tracking automatically traced the RV endocardium and analyzed the RV function of the participants. The median global 3D RV-ACR was - 31.6% [interquartile range (IQR): - 33.4 to - 30.0%] and demonstrated a significant correlation with 3D-RVEF (r = 0.8957, p < 0.0001). The median values for the 3D RV inlet, RV outflow tract, and apical ACRs were - 36.3% (IQR: - 38.7 to - 34.6%), - 28.5% (IQR: - 32.5 to - 25.8%), and - 23.8% (IQR: - 27.1 to - 20.1%), respectively. Their contributions to the 3D-RVEF were 35.0%, 32.3%, and 4.2%, and to the global 3D RV-ACR were 44.5%, 39.6%, and 11.1%, respectively.

Conclusions: The 3D RV-ACRs determined by the novel RV-specialized automatic 3D-STE analysis enable precise and quantitative assessment of RV function.