Right ventricular volumes and function indices by automated 3D speckle tracking echocardiography with artificial intelligence software

Abstract Introduction Normal values of three dimensional right ventricular (RV) volumes, ejection fraction (EF) and systolic function indices by three - dimensional speckle tracking echcardiography (3D - STE) are not well established. All measurements relied on older 3D RV software analysis and most of these are operator - depended with a wide variability in measured values. The gold standard method for evaluation of RV volumes and EF remains the Magnetic Resonance Imaging (MRI)despite the rapid improvement in echocardiography softwares for RV evaluation. Purpose Aim of the study was to assess the feasibility of modern advanced technology echocardiographic software based on 3D imaging powered by Artificial Intelligence (AI) in measurement of RV volumes, RV EF and systolic function indices by 3D - STE in normal subjects. Methods Healthy subjects without any cardiovascular, pulmonary and renal disease, underwent complete echocardiographic evaluation including the 3D datasets from each of the parasternal, apical and subcostal views. 3D RV datasets were obtained and analyzed using RV software powered by AI, to measure Global RV Volumes, End - Diastolic volume (EDV), End - Systolic volume (ESV), RV EF and Tricuspid Annular Plane Systolic Excursion (TAPSE). Additionally 3D Free Wall Longitudinal Strain (FWLS) and 3D Global Strain (3D GS) were obtained. Three or more datasets obtained from the apical view were available for comprehensive analysis in each subject. Results Of the 54 healthy subjects, 40 (50% male and 50% female, mean age 51 +/- 15 years old) had adequate image quality for measurements. Mean indexed 3D EDV, ESV and RV EF were measured at 48.5 +/- 10.3 mL/m2, 16.7 +/- 5.8 mL/m2, 56,1 +/- 5.9 % respectively. in addition 3D FWLS and 3D GS were measured at - 27.9 +/- 4.5 % and - 24.7 +/- 3.6 % respectively. TAPSE was measured at 22.4 +/- 5.1 mm. Conclusions Modern softwares based on AI are a new era in Cardiology and Echocardiography. A rapid increase of AI contribution in cardiovascular imaging techiniques is expected in the near future. 3D RV acquisition is feasible in the majority of subjects, although the quality of imaging and appropriate echocardiographic views remains operator - depended. Reference values of 3D RV volumes and 3D - STE systolic function indices were obtained by advanced technology AI software. Larger studies are required to establish normal values for the above indices.