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Comparison of semi-automated versus manual quantitative right ventricular assessment in tetralogy of Fallot

Part of: Tetralogy of Fallot (TOF) Echocardiography

Published online by Cambridge University Press:  09 March 2021

Joanna Lowisz ,
Francis J. Alenghat ,
Yi Li ,
David Roberson ,
Jamie Penk  and
Rupali Gandhi Open the ORCID record for Rupali Gandhi [Opens in a new window]
Joanna Lowisz
Affiliation:
Department of Pediatric Cardiology, Children’s Hospital Minnesota, Minneapolis, MN, USA
Francis J. Alenghat
Affiliation:
Department of Medicine, Section of Cardiology, University of Chicago, Chicago, IL, USA
Yi Li
Affiliation:
Department of Pediatric Cardiology, Advocate Children’s Hospital, Oak Lawn, IL, USA
David Roberson
Affiliation:
Department of Pediatric Cardiology, Advocate Children’s Hospital, Oak Lawn, IL, USA
Jamie Penk
Affiliation:
Department of Pediatric Cardiology, Lurie Children’s Hospital, ChicagoIL, USA
Rupali Gandhi*
Affiliation:
Department of Pediatric Cardiology, Advocate Children’s Hospital, Oak Lawn, IL, USA
*
Author for correspondence: Rupali Gandhi, MD, JD, Department of Pediatric Cardiology, Advocate Children’s Hospital, Chicago, IL, 4440 W, USA. 95th Street, Oak Lawn, IL, 60453. Phone: 708-684-5580. E-mail: Rupali.Gandhi@advocatehealth.com
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Abstract

Background:

Tetralogy of Fallot is a congenital heart defect diagnosed in infancy. Assessment of right ventricular size and function is important for evaluation of patients with tetralogy of Fallot, but these quantitative measures are challenging by echocardiography. This study evaluates a semi-automated software (EchoInsight®, Epsilon Imaging) by comparing its measures to manual measures in children with tetralogy of Fallot.

Methods:

Echocardiographic measurements were performed using manual techniques and semi-automated software. Right ventricular measurements included end-diastolic and end-systolic area, fractional area change, chamber dimensions, and tricuspid annular plane systolic excursion. Reliability, correlation, and agreement between manual and semi-automated measures were assessed.

Results:

Echocardiograms for 46 patients were analysed. Intra- and inter-observer reliabilities for semi-automated measures were good with intraclass correlation coefficients all over 0.95 and 0.85, respectively. There was high correlation between manual and semi-automated methods for areas and dimensions (r = 0.91–0.98). Tricuspid annular plane systolic excursion measures and fractional area change also correlated, albeit less strongly. The semi-automated measurements of end-systolic and end-diastolic area were a 20 and 47% higher than manual methods, respectively.

The semi-automated method yielded a relative 52% lower fractional area change compared to the manual method.

Conclusions:

The semi-automated software generates quantitative right ventricular measures in children with tetralogy of Fallot with good reliability and good correlation with manual methods for all measures, but with significant difference between manual and semi-automated techniques for area and functional measures. The specific right ventricular geometry in tetralogy of Fallot children may be why, compared to normal anatomy, greater differences were observed between the two techniques.

Keywords

Paediatric cardiologytetralogy of Fallotright ventricular measurementsechocardiographyepsilonechoInsightsemi-automated measurementsfractional area change
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 11 , November 2021 , pp. 1781 - 1787
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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