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Abstract Q uantitative echocardiographic assessment of right ventricular (RV) function is becoming of increasing interest in cardiac diseases that affect the right ventricle, such as congenital heart disease and acute or chronic pulmonary hypertension (PH), but is still challenging due to RV complex anatomy and structure. Evaluation of RV function is particularly important in chronic PH since the primary cause of death is RV failure that is highly associated with RV parameters such as cardiac index and right atrial pressure. Two dimensional echocardiographic methods of analyzing RV performance employ geometric models that do not represent the irregular RV shape accurately. Real‐time three dimensional echocardiography allows us to measure RV end‐diastolic volume and ejection fraction irrespective of its shape and more reliably compare it to 2DE and evaluate the morphologic and functional remodeling of the right ventricle in PH. In addition, RV quantification by angiography has not been studied before in the context of congenital heart disease complicated with pulmonary hypertension. The hemodynamic value of these new angiography and echocardiographic parameters in the clinical setting of PH and RV failure was not clearly established. Accordingly, we sought to analyze the use of angiography and 3DE in the assessment of RV function in patients with chronic PH in congenital heart disease to evaluate whether these parameters could detect hemodynamic signs of pulmonary artery and RV failure better than conventional echo indices. In this study, we included 50 patients with different congenital heart disease presented with shunt lesions and variable degrees of pulmonary hypertension. 2D and 3D echocardiography were conducted together with invasive right heart catheterizations. Data was retrieved from these procedures and analyzed together to find strong correlation between echocardiography and angiographic indices with PVR and RV failure, ending up with formulating list of predictors that can be conducted both non invasively and angiographically for detection of irreversibility of PH and RV failure. The 3D echocardiographic and angiography indices are : • 3D EF. • 3D annulus area of TV. • 3D TV tenting volume. • 3D models of RV • RV EF quantification by angiography. We finally concluded that, in PH patients, the qualitative and quantitative assessment of global and regional RV function by 3D echocardiography and angiography provided us with useful hemodynamic and prognostic information. |