Assessment of right ventricular and right atrial systolic and diastolic performance using automated border detection

Noninvasive assessment of right ventricular (RV) function is important clin ically, but current techniques have limitations. Acoustic quantification (A Q) is an automated endocardial border detection technique that allows conti nuous determination of RV and right atrial (RA) area waveforms and may be u seful for the assessment of RA and RV systolic and diastolic performance. F ifty patients (10 normal, 40 with RV pathology) were studied. Signal-averag ed RA and RV AQ area waveforms were obtained and analyzed to compute parame ters of diastolic and systolic function. All groups demonstrated significan t diastolic dysfunction on the RA AQ wave form as manifested by a reduced p ercentage of passive atrial emptying and increased dependence on, active at rial emptying. Abnormalities of diastolic performance were noted in all sub groups on RV AQ analysis as evidenced by a reduction in the percentage of v entricular filling occurring during early diastole and an increased contrib ution from active atrial contraction. This study demonstrates the feasibili ty of using automated analysis of signal-averaged RA and RV area waveforms for the evaluation of RV systolic and diastolic performance. This technique identified significant systolic and diastolic dysfunction in four groups o f commonly seen right heart pathologies including biventricular heart failu re, pulmonary hypertension, pressure and volume overloaded RVs, and biventr icular hypertrophy.