Skip to main content Accessibility help
×
Home
Hostname: page-component-568f69f84b-lkk24 Total loading time: 0.536 Render date: 2021-09-22T05:01:54.652Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Semi-automated speckle-tracking for quantitative right ventricular assessment in children and adolescents

Published online by Cambridge University Press:  15 August 2019

Aron K. McCloud*
Affiliation:
Division of Pediatric Cardiology, Advocate Children’s Hospital, Oak Lawn, IL, USA Division of Pediatric Cardiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
Joanna Lowisz
Affiliation:
Division of Pediatric Cardiology, Advocate Children’s Hospital, Oak Lawn, IL, USA
David A. Roberson
Affiliation:
Division of Pediatric Cardiology, Advocate Children’s Hospital, Oak Lawn, IL, USA
Cheryl A. Lefaiver
Affiliation:
Center for Pediatric Research, Advocate Children’s Hospital, Oak Lawn, IL, USA
Jamie S. Penk
Affiliation:
Division of Pediatric Cardiology, Advocate Children’s Hospital, Oak Lawn, IL, USA
*Corresponding
Author for correspondence: A. K. McCloud, DO, Division of Pediatric Cardiology, University of Virginia, 629 Cedar Creek Grade, Suite B, Winchester, VA 22601, USA. Tel: (540) 678-3950; Fax: (540) 678-3954; E-mail: akm6v@virginia.edu

Abstract

Background:

Assessment of right ventricular size and function is an important part of the clinical cardiac evaluation; however, these quantitative measures are challenging by echocardiography. Automated software could be useful in place of manual measurements and qualitative assessment. This study evaluates a semi-automated software by comparing automated to manual measures in normal children.

Methods:

Neonates to adolescents with normal echocardiograms were prospectively enrolled. Measurements were performed using manual techniques and semi-automated software (EchoInsight®, Epsilon Imaging, Ann Arbor, Michigan, United States of America). Right ventricular measurements included end-diastolic and end-systolic area, fractional area change, chamber dimensions, and tricuspid annular plane systolic excursion. Agreement between manual and semi-automated measures was compared.

Results:

Echocardiograms for 233 patients were included in the analysis. Intra- and inter-observer reliabilities for semi-automated measures were good with intraclass correlation coefficients all over 0.9 and 0.85, respectively. There was very strong correlation between manual and semi-automated methods for areas and dimensions (r = 0.93–0.99) and low bias (1.4–10.8%). For functional measures, tricuspid annular plane systolic excursion measures correlated well (r = 0.84), but fractional area change did not (r = 0.50). Both demonstrated significant bias (33.5–43.0%). The semi-automated method consistently underestimated fractional area change with a mean of 26.6% versus a manual mean of 36.1%.

Conclusions:

The semi-automated software is capable of generating quantitative right ventricular measures in children with good reliability. The software demonstrates very good correlation and low bias when compared to manual methods for right ventricular areas and dimensions. There is a significant difference between manual and semi-automated techniques for the functional measures.

Type
Original Article
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Presented at the 21st Annual Update on Pediatric and Congenital Cardiovascular Disease, Scottsdale, AZ, USA, 23 February 2018.

References

Lai, WW, Geva, T, Shirali, GS, et al. Guidelines and standards for performance of a pediatric echocardiogram: a report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr 2006; 19: 14131430. doi: 10.1016/j.echo.2006.09.001.CrossRefGoogle ScholarPubMed
Lopez, L, Colan, SD, Frommelt, PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Coll Cardiol 2010; 23: 465495. doi: 10.1016/j.echo.2010.03.019.Google ScholarPubMed
Saguner, AM, Vecchiati, A, Baldinger, SH, et al. Different prognostic value of functional right ventricular parameters in arrhythmogenic right ventricular cardiomyopathy/dysplasia. Circ Cardiovasc Imaging 2014; 7: 230239. doi: 10.1161/CIRCIMAGING.113.000210.CrossRefGoogle ScholarPubMed
Leong, DP, Höke, U, Delgado, V, et al. Right ventricular function and survival following cardiac resynchronisation therapy. Heart 2013; 99: 722728. doi: 10.1136/heartjnl-2012-303076.CrossRefGoogle ScholarPubMed
Mahle, WT, Coon, PD, Wernovsky, G, et al. Quantitative echocardiographic assessment of the performance of the functionally single right ventricle after the Fontan operation. Cardiol Young 2001; 11: 399406.CrossRefGoogle ScholarPubMed
Davlouros, PA, Niwa, K, Webb, G, et al. The right ventricle in congenital heart disease. Heart 2006; 92 (Suppl 1): i27i38. doi: 10.1136/hrt.2005.077438.CrossRefGoogle ScholarPubMed
Lang, RM, Bierig, M, Devereux, RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Associateion of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005; 18: 14401463. doi: 10.1016/j.echo.2005.10.005.CrossRefGoogle Scholar
Mor-Avi, V, Lang, RM, Badano, LP, et al. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. J Am Soc Echocardiogr 2011; 24: 277313. doi: 10.1016/j.echo.2011.01.015.CrossRefGoogle ScholarPubMed
Van der Zwaan, HB, Geleijnse, ML, McGhie, JS, et al. Right ventricular quantification in clinical practice: two-dimensional vs. three-dimensional echocardiography compared with cardiac magnetic resonance imaging. Eur J Echocardiogr 2011; 12: 656664. doi: 10.1093/ejechocard/jer107.CrossRefGoogle ScholarPubMed
Bleeker, GB, Steendijk, P, Holman, ER, et al. Assessing right ventricular function: the role of echocardiography and complementary technologies. Heart 2006; 92 (Suppl 1): i19i26. doi: 10.1136/hrt.2005.082503.CrossRefGoogle ScholarPubMed
Wang, J, Prakasa, K, Bomma, C, et al. Comparison of novel echocardiographic parameters of right ventricular function with ejection fraction by cardiac magnetic resonance. J Am Soc Echocardiogr 2007; 20: 10581064. doi: 10.1016/j.echo.2007.01.038.CrossRefGoogle ScholarPubMed
Tamborini, G, Pepi, M, Galli, CA, et al. Feasibility and accuracy of a routine echocardiographic assessment of right ventricular function. Int J Cardiol 2007; 115: 8689. doi: 10.1016/j.ijcard.2006.01.017.CrossRefGoogle ScholarPubMed
Lai, WW, Gauvreau, K, Rivera, ES, et al. Accuracy of guideline recommendations for two-dimensional quantification of the right ventricle by echocardiography. Int J Cardiovasc Imaging 2008; 24: 691698. doi: 10.1007/s10554-008-9314-4.CrossRefGoogle ScholarPubMed
Kopecna, D, Briongos, S, Castillo, H, et al. Interobserver reliability of echocardiography for prognostication of normotensive patients with pulmonary embolism. Cardiovasc Ultrasound 2014; 12: 29. doi: 10.1186/1476-7120-12-29.CrossRefGoogle ScholarPubMed
Michalis, LK, Thomas, MR, Jewitt, DE, et al. Echocardiographic assessment of systolic and diastolic left ventricular function using an automatic boundary detection system. Correlation with established invasive and non invasive parameters. Int J Card Imaging 1995; 11: 7180. doi: 10.1007/BF01844704 CrossRefGoogle ScholarPubMed
Yagi, T, Yoshida, K, Hozumi, T, et al. Automatic assessment of left ventricular cavity area by the automated contour tracking method. J Cardiol 1996; 28: 345348.Google ScholarPubMed
Sugioka, K, Hozumi, T, Yagi, T, et al. Automated quantification of left ventricular function by the automated contour tracking method. Echocardiography 2003; 20: 313318. doi: 10.1046/j.1540-8175.2003.03036.CrossRefGoogle ScholarPubMed
Rahmouni, HW, Ky, B, Plappert, T, et al. Clinical utility of automated assessment of left ventricular ejection fraction using artificial intelligence-assisted border detection. Am Heart J 2008; 155: 562570. doi: 10.1016/j.ahj.2007.11.002.CrossRefGoogle ScholarPubMed
Oe, M, Gorcsan, J 3rd, Mandarino, WA, et al. Automated echocardiographic measures of right ventricular area as an index of volume and end-systolic pressure-area relations to assess right ventricular function. Circulation 1995; 92: 10261033.CrossRefGoogle ScholarPubMed
Forni, G, Pozzoli, M, Cannizzaro, G, et al. Assessment of right ventricular function in patients with congestive heart failure by echocardiographic automated boundary detection. Am J Cardiol 1996; 78: 13171321. doi: 10.1016/S0002-9149(96)00623-6.CrossRefGoogle ScholarPubMed
Greiner, S, André, F, Heimisch, M, et al. Non-invasive quantification of right ventricular systolic function by echocardiography: a new semi-automated approach. Clin Res Cardiol 2013; 102: 229235. doi: 10.1007/s00392-012-0528-z.CrossRefGoogle ScholarPubMed
Kimball, TR, Witt, SA, Khoury, PR, et al. Automated echocardiographic analysis of systemic ventricular performance in hypoplastic left heart syndrome. J Am Soc Echocardiogr 1996; 9: 629636.CrossRefGoogle ScholarPubMed
Helbing, WA, Bosch, HG, Maliepaard, C, et al. On-line automated border detection for echocardiographic quantification of right ventricular size and function in children. Pediatr Cardiol 1997; 18: 261699. doi: 10.1007/s002469900171.CrossRefGoogle ScholarPubMed
Gao, Z, Bortman, J, Mahmood, F, et al. Vendor-neutral right ventricular strain measurement. J Cardiothorac Vasc Anesth 2018; 32: 17591767. doi: 10.1053/j.jvca.2018.02.014.CrossRefGoogle ScholarPubMed
Medvedofsky, D, Addetia, K, Hamilton, J, et al. Semi-automated echocardiographic quantification of right ventricular size and function. Int J Cardiovasc Imaging 2015; 31: 11491157. doi: 10.1007/s10554-015-0672-4.CrossRefGoogle ScholarPubMed
Bland, M, Altman, DG. Applying the right statistics: analyses of measurement studies. Ultrasound Obstet Gynecol 2003; 22: 8593. doi: 10.1002/uog.122.CrossRefGoogle ScholarPubMed
Knight, DS, Schwaiger, JP, Krupickova, S, et al. Accuracy and test-retest reproducibility of two-dimensional knowledge-based volumetric reconstruction of the right ventricle in pulmonary hypertension. J Am Soc Echocardiogr 2015; 28: 989998. doi: 10.1016/j.echo.2015.02.020.CrossRefGoogle ScholarPubMed

McCloud et al. supplementary material

McCloud et al. supplementary material 1

Download McCloud et al. supplementary material(Video)
Video 32 MB
2
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Semi-automated speckle-tracking for quantitative right ventricular assessment in children and adolescents
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Semi-automated speckle-tracking for quantitative right ventricular assessment in children and adolescents
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Semi-automated speckle-tracking for quantitative right ventricular assessment in children and adolescents
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *