Volume 36, Issue 1 pp. 94-101

ORIGINAL INVESTIGATION

Teamwork using strain imaging in the echocardiographic assessment of right ventricular systolic function: A cardiac magnetic resonance imaging correlation study

Bo Xu MBBS (Hons), FRACP,

Bo Xu MBBS (Hons), FRACP

orcid.org/0000-0002-2985-7468

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Richard A. Grimm DO,

Richard A. Grimm DO

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Christine L. Jellis MBBS, PhD,

Christine L. Jellis MBBS, PhD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Patrick Collier MD, PhD,

Patrick Collier MD, PhD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Milind Y. Desai MD,

Milind Y. Desai MD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Dermot Phelan MD, PhD,

Dermot Phelan MD, PhD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Maran Thamilarasan MD,

Maran Thamilarasan MD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Luis Leonardo Rodriguez MD,

Luis Leonardo Rodriguez MD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Scott D. Flamm MD, MBA,

Scott D. Flamm MD, MBA

Cardiovascular Imaging Laboratory, Imaging Institute, and Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Kimi Sato MD, PhD,

Kimi Sato MD, PhD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Serge C. Harb MD,

Serge C. Harb MD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Zoran B. Popovic MD, PhD,

Corresponding Author

Zoran B. Popovic MD, PhD

[email protected]

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

Correspondence

Dr. Zoran B. Popovic, MD, PhD, Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH.

Email: [email protected]

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Bo Xu MBBS (Hons), FRACP,

Bo Xu MBBS (Hons), FRACP

orcid.org/0000-0002-2985-7468

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Richard A. Grimm DO,

Richard A. Grimm DO

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Christine L. Jellis MBBS, PhD,

Christine L. Jellis MBBS, PhD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Patrick Collier MD, PhD,

Patrick Collier MD, PhD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Milind Y. Desai MD,

Milind Y. Desai MD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Dermot Phelan MD, PhD,

Dermot Phelan MD, PhD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Maran Thamilarasan MD,

Maran Thamilarasan MD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Luis Leonardo Rodriguez MD,

Luis Leonardo Rodriguez MD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Scott D. Flamm MD, MBA,

Scott D. Flamm MD, MBA

Cardiovascular Imaging Laboratory, Imaging Institute, and Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Kimi Sato MD, PhD,

Kimi Sato MD, PhD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Serge C. Harb MD,

Serge C. Harb MD

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

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Zoran B. Popovic MD, PhD,

Corresponding Author

Zoran B. Popovic MD, PhD

[email protected]

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio

Correspondence

Dr. Zoran B. Popovic, MD, PhD, Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH.

Email: [email protected]

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First published: 23 November 2018

https://doi.org/10.1111/echo.14199

Citations: 2

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Abstract

Aim

The aim of this study was to investigate whether conventional echocardiographic assessment of right ventricular (RV) systolic function can be improved by the addition of RV strain imaging. Additionally, we also aimed to investigate whether dedicated reading sessions and education can improve echocardiographic interpretation of RV systolic function.

Methods

Readers of varying expertise (staff echocardiologists, advanced cardiovascular imaging fellows, sonographers) assessed RV systolic function. In session 1, 20 readers graded RV function of 19 cases, using conventional measures. After dedicated education, in session 2, the same cases were reassessed, with the addition of RV strains. In session 3, 18 readers graded RV function of 20 additional cases, incorporating RV strains. Computer simulations were performed to obtain 230 random teams. RV ejection fraction (RVEF) by cardiac magnetic resonance (CMR) was the reference standard.

Results

Correlation between RV GLS and CMR-derived RVEF was moderate: Spearman's rho: 0.70, n = 19, P < 0.001 (first two sessions); 0.55, n = 20, P < 0.05 (third session). Individual readers’ assessment moderately correlated with RVEF (Spearman's rho first session: 0.67 ± 0.2; second session: 0.61 ± 0.2; and third session: 0.68 ± 0.09). Team estimates of RV systolic function showed consistently better correlation with RVEF, which were improved further by averaging across all readers. RV strain parameters influenced echocardiographic interpretation, with a net reclassification index of 8.0 ± 3.6% (P = 0.014).

Conclusions

The RV strain parameters showed moderate correlations with CMR-derived RVEF and appropriately influenced echocardiographic interpretation of RV systolic function. “Wisdom of the crowd” applied by averaging echocardiographic assessments of RV systolic function across teams of echocardiography readers, further improved echocardiographic assessment of RV systolic function.

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Volume36, Issue1

January 2019

Pages 94-101

Teamwork using strain imaging in the echocardiographic assessment of right ventricular systolic function: A cardiac magnetic resonance imaging correlation study

Abstract

Aim

Methods

Results

Conclusions

REFERENCES

Citing Literature

References

Information

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Teamwork using strain imaging in the echocardiographic assessment of right ventricular systolic function: A cardiac magnetic resonance imaging correlation study

Abstract

Aim

Methods

Results

Conclusions

REFERENCES

Citing Literature

References

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