Three-Dimensional Echocardiographic Evaluation of the Right Ventricle in Normal Egyptian Children

The right ventricle (RV) is a major determinant of clinical outcomes in different cardiopulmonary disorders. Quantification of the RV with 2D echocardiography is challenging because of its complex asymmetrical geometry.1,2 Three-dimensional echocardiography is becoming more prevalent in children because of good acoustic windows and the noninvasive nature of the technique. Three-dimensional echocardiography allows the measurement of RV volumes, thereby overcoming the limitations of 2D echocardiography.3
A prospective observational cross-sectional study was performed on 450 normal Egyptian children randomly chosen including both sexes. The subjects were divided into 2 age groups. ECG-gated 2D and 3D transthoracic echocardiography was done to evaluate RV parameters.
The feasibility of 3D echocardiography was 96%. Mean indexed RVEDV was 40.5±5.4 mL/m2 in boys and 40.1±5.8 mL/m2 in girls, mean indexed RVESV was 18.8±3.7 mL/m2 in boys and 18.7±3.7 mL/m2 in girls, mean indexed stroke volume was 21.6±3.1 mL/m2 in boys and 21.3±3.6 mL/m2 in girls, and mean RVEF was 53.7±5.1% in boys and 53.5±5.4% in girls. A significant negative correlation existed between 3DE RVEF and ESV. A strong positive correlation was observed between mean 3DE RVESV and mean 3DE RVEDV. Further, 2DE and 3DE RVESV and EDV mean indexed and absolute values showed significant differences. Additionally, 2DE and 3DE FAC mean values showed positive significant correlations, and 3DE FAC and RVEF showed modest positive correlations.
Three-dimensional echocardiography provides RV volume quantification and functional assessment without any geometric assumptions. Reference values and percentile curves were established for RV parameters by 3DE for the first time in the Egyptian children population. (Iranian Heart Journal 2022; 23(2): 42-52)