BACKGROUND Right ventricular (RV) function plays a pivotal prognostic role in multiple cardiac diseases. Echocardiography guidelines recommend that RV quantification be performed in the RV-focused view, which is theoretically more reproducible than the four-chamber (4Ch) view. However, differences between views in RV size and function measurements have never been systematically studied. Accordingly, the aim of this study was to compare (1) RV size and function parameters obtained from the RV-focused and 4Ch views and (2) test-retest variability between these two views. METHODS Fifty patients (26 men; mean age, 63 ± 18 years) undergoing clinically indicated transthoracic echocardiography were prospectively enrolled. Each patient underwent three repeated acquisitions of the 4Ch and RV-focused views by two sonographers. The first operator performed two acquisitions at the beginning and the end of the clinical transthoracic echocardiographic study, and the second operator performed the third acquisition afterward. RV size and function measurements were obtained from the two views and compared using paired t-test analysis and Bland-Altman analysis. Intra- and interoperator test-retest and intra- and interreader variability for both views were assessed using intraclass correlations and coefficients of variation. RESULTS All RV size parameters were significantly larger when measured in the RV-focused view compared with the 4Ch view. Also, all RV function parameters, including RV free wall and global longitudinal strain, were larger in magnitude when measured in the RV-focused view. Measurements variability was consistently better for the RV-focused view. CONCLUSIONS RV size and function measurements obtained from the RV-focused and 4Ch views are not interchangeable. RV size and function parameters measured from the RV-focused view are more reproducible than from 4Ch acquisitions. Therefore, only the RV-focused view should be used for quantitative assessment of the right ventricle.

中文翻译：

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四腔室和右心室重点视图之间的比较，用于定量评估右心室的大小和功能。

背景技术右心室（RV）功能在多种心脏病中起着至关重要的预后作用。超声心动图指南建议在以RV为中心的视图中进行RV定量，从理论上讲，该定量比四腔（4Ch）视图可重复性更高。但是，尚未对RV大小和功能测量的观点之间的差异进行系统研究。因此，本研究的目的是比较（1）从以RV为重点的视图和4Ch视图获得的RV大小和功能参数，以及（2）这两个视图之间的重测变异性。方法前瞻性入选了50例行临床经胸超声心动图检查的患者（26名男性，平均年龄63±18岁）。每位患者均由两名超声检查师进行了3次重复的4Ch和RV聚焦观察。第一位操作者在临床经胸超声心动图研究的开始和结束时进行了两次采集，第二位操作者随后进行了第三次采集。RV大小和功能测量值从两个视图中获得，并使用配对t检验分析和Bland-Altman分析进行比较。使用类内相关性和变异系数来评估两种视图的操作员内部和操作员之间的重新测试以及阅读器内部和阅读器之间的变异性。结果与4Ch视图相比，在RV聚焦视图中测量的所有RV尺寸参数均明显更大。同样，在RV聚焦视图中进行测量时，所有RV功能参数（包括RV自由壁和整体纵向应变）的大小都较大。对于以RV为中心的视图，测量的可变性始终更好。结论从以RV为重点的视图和4Ch视图获得的RV大小和功能测量不可互换。从以RV为中心的视图中测量的RV大小和功能参数比从4Ch采集中获得的结果更具可重复性。因此，仅右心室视图应用于右心室的定量评估。