Right ventricular assessment using ultrasound in a healthy, multi-ethnic population

  • James Willis

Student thesis: Doctoral ThesisPhD


Current published reference values for right ventricular (RV) echocardiographic assessment do not adequately account for the reported changes in size and function that can occur due to gender, age and body size. In addition, the potential effects on RV dimensions of ethnic variation within healthy volunteers are relatively unknown. The aim of this study was to better understand the potential differences in RV size that may result from gender, body size, ethnicity or age in a healthy volunteer group. 255 healthy volunteers (mean age 41+11 years 53% male) from five ethnic groups (Indian, Chinese, Malay, European, Afro-Caribbean) were recruited. Assessment of RV size was conducted using 2D calliper measurements, 3D volume, ejection fraction (EF) and RV deformation characteristics (peak systolic strain (PSS) and strain rate (PSSR)). Intraobserver, interobserver and test-retest scenarios were performed to assess measurement variability and reliability. Regression analysis identified gender, age, body size and ethnicity as significant coefficients of 2D RV size and 3D volume. European and Afro-Caribbean 2D and 3D measurements were on average larger than the remaining ethnic groups whilst males exceeded females. Allometric scaling of the raw 2D data to body surface area (BSA) resulted in gender and body size independent measurements whilst measurements between ethnic groups displayed varying significance on both RV size and volume. Increasing age resulted in a number of significant interactions with size and volume. Gender differences were apparent for both 3D ejection fraction (EF) and strain measurements. Females displayed both higher 3D EF and PSS using an RV freewall approach. The reproducibility of the RV measurements varied depending on the method used and the scenario undertaken. Gender, age and body size are important determinants of 2D linear deformation, and 3D acquired RV measurements. These results highlight the need for 4 appropriate allometric scaling of RV measurements to BSA, whilst highlighting the importance of documenting ethnicity
Date of Award3 Jul 2014
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorRex Tyrrell (Supervisor)

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