Correlations between echocardiographic and CMR-derived parameters of right ventricular function in COPD
█ Original article
Hajdu Máté, Vértes Vivien oh., Meiszterics Zsófia, Szabados Sándor, Faludi Réka, Simor Tamás
Pécsi Tudományegyetem Klinikai Központ, Szívgyógyászati Klinika, Pécs
Background: In COPD right ventricular (RV) failure is linked to worse outcome. Though echocardiography is the common method for the assessment of RV size and function, its clinical value in COPD is not well defined. CMR is the reference technique, but it is not known, if trabeculae and papillary muscles should be included or excluded from the muscles during analysis. Thus we aimed to investigate the correlations between echocardiographic and CMR-derived parameters of the RV size and function in COPD patients. In addition, our aim was to determine the impact of including trabeculae and papillary muscles on RV volumes and function as assessed by CMR.
Patients and methods: 22 COPD patients (62±9 years) in stages GOLD II. and III. were involved. RV end-systolic (ES) and end-diastolic (ED) area and RV wall thickness were measured by echocardiography. RV function was assessed by TAPSE, RVFAC and tricuspid annular systolic velocity (S). RV volume (MR-volume), RV ejection fraction (MR-EF), RV mass index (MR-mass index) were measured by CMR. With manual contour tracing trabeculae and papillary muscles were excluded from the RV muscles. Semi-automatic pixel-intensity based software was used to include trabeculae and papillary muscles to the RV muscles.
Results: RV diameters and areas showed significant correlation with MR-volume values while RV wall thickness with MR-mass index. TAPSE and tricuspid S values normalized to RV long axis diameter showed significant correlation with MR-EF. No correlation was found between RVFAC and MR-EF. Inclusion of trabeculae resulted in significantly decreased MR-volume values (ED: –26.5±9.6; ES: –17.3±6.9 ml). MR-EF (+3.6±2.6%) and MR-mass index (ED: +27.8±10.0; ES: +18.1±7.2 g/m2) increased significantly.
Conclusion: Echocardiography may be routinely used in the clinical setting to estimate RV size and function in COPD. TAPSE and tricuspid S are the preferable parameters when estimating RV function. Inclusion of trabeculae and papillary muscles during CMR analysis has a significant impact on MR-derived volumes, mass and EF.