Simplified echocardiographic assessment of right ventricular function

PURPOSE: Assessment of right ventricular (RV) systolic function is complex and most methods require sophisticated data analysis. We developed a simplified method to assess RV function and evaluate it in states of chronic pressure overload, volume overload and acute RV infarction. METHODS: We hypothesized that RV volume could be estimated as one-fourth of a rhomboid ellipse and calculated by the simple formula, 1.04 (sax²)×(lax). The measurements of lax (longitudinal axis), sax (sagittal axis) were done during diastole and systole on apical four chamber views. TAPSE (Tricuspid annulus planner systolic excursion), another assessment of RV systolic function, was also measured on apical four chamber views. We retrospectively studied sixty-four patients, sixteen in each group, admitted during years 1992-94. We identified normals, mitral stenosis (MS), atrial septal defect (ASD) and RV infarction (RVI) on the basis of clinical and cardiac catheterization finding. Complete echocardiograms done during the hospitalization were analyzed. RESULTS: RV diastolic volume index RV ejection Tapse (cm³/m²) fraction (%) (cm) Normal 42±14 59±11 1.9±0.54 MS 42±17 46±18 1.6±0.16 ASD 67±19 59±07 2.1±0.68 RVI 55±21 33±16 0.6±0.36 (Mean ± Standard Deviation) CONCLUSION: Our simplified method allowed estimation of RV size and systolic function. The estimation of RV ejection fraction correlated with TAPSE. CLINICAL IMPLICATIONS: The described technique can be used as quick bedside echocardiographic method to assess RV size and systolic function in different clinical conditions and obviates the need for sophisticated software and data analysis.