Open Access
ARTICLE
Assessing Univentricular Function in Adult Fontan Using 3D Echocardiography
Karina V. Bunting1,2,*, Francesco Formisano3, Jennifer Green1, Richard P. Steeds1,2, Lucy Hudsmith1, Paul Clift1,2
1 University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
2 Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
3 Worcestershire Acute Hospitals NHS Trust, Worcester, UK
* Corresponding Author: Karina V. Bunting. Email:
Congenital Heart Disease 2020, 15(2), 89-100. https://doi.org/10.32604/CHD.2020.011376
Received 05 May 2020; Accepted 17 June 2020; Issue published 23 June 2020
Abstract
Objective: To determine the accuracy of assessing univentricular
function in adult Fontan patients using three-dimensional (3D) volumetric
echocardiography.
Design: A prospective observational study in an adult Fontan
patient cohort.
Setting: University Hospitals Birmingham, NHS Foundation
Trust.
Patients: 26 patients were enrolled in the study all aged over 18 years,
possessing the Fontan anatomy, with no contraindications to Cardiac Magnetic
Resonance (CMR) imaging and in sinus rhythm.
Intervention: All patients
underwent transthoracic echocardiography using a Philips EPIQ 7 and X5-1
transducer. End diastolic volume (EDV), end systolic volume (ESV), stroke
volume (SV) and ejection fraction (EF) were obtained using two dimensional
(2D) and 3D acquisitions. CMR was performed within 3 months according to
standard protocols.
Outcome Measures: The agreement and correlation between
2D, 3D and CMR derived parameters were determined by Bland and Altman
analysis and Pearson’s correlation coefficient method. The inter-observer
variability was also assessed for all three modalities.
Results: 3D volumetric
acquisitions of the single ventricle were feasible in 18/26 (69%) patients. 3D
volumes strongly correlated with CMR but with a systematic bias to underestimation: EDV r = 0.66, bias = –47.1 (–109.6 to 15.2); ESV r = 0.82, bias = –
19.4 (–59.9 to 21.1); EF r = 0.73, –1.56 (–18.8 to 15.7) and SV r = 0.32, –27.7 (–
70.2 to 14.7). Inter-observer variability was lowest with CMR, when compared
to echocardiographic techniques. The inter-observer variability for 3D when
compared with 2D echocardiography was lower across all parameters except
EDV.
Conclusions: 3D volumes correlate strongly with CMR and may be used
for serial assessment of univentricular function. However, 3D volumes on echo
are not interchangeable with CMR due to systematic underestimation of volume.
Keywords
Cite This Article
APA Style
Bunting, K.V., Formisano, F., Green, J., Steeds, R.P., Hudsmith, L. et al. (2020). Assessing univentricular function in adult fontan using 3D echocardiography. Congenital Heart Disease, 15(2), 89-100. https://doi.org/10.32604/CHD.2020.011376
Vancouver Style
Bunting KV, Formisano F, Green J, Steeds RP, Hudsmith L, Clift P. Assessing univentricular function in adult fontan using 3D echocardiography. Congeni Heart Dis. 2020;15(2):89-100 https://doi.org/10.32604/CHD.2020.011376
IEEE Style
K.V. Bunting, F. Formisano, J. Green, R.P. Steeds, L. Hudsmith, and P. Clift "Assessing Univentricular Function in Adult Fontan Using 3D Echocardiography," Congeni. Heart Dis., vol. 15, no. 2, pp. 89-100. 2020. https://doi.org/10.32604/CHD.2020.011376