PhD Scientific Days 2026

Poster Session 3.R - Cardiovascular Medicine and Research

Shape Matters: 3D Echocardiographic Characterization of Global Right Ventricular Geometry Across Health and Disease

Name of the presenter

Fábián, Alexandra

Institute/workplace of the presenter

Semmelweis University, Heart and Vascular Center

Authors

Alexandra Fábián¹, Andrea Ferencz¹, Janka Hatvani², Bálint Magyar², Ádám Szijártó¹, Martin Gruca³, Juan Cotella³, Bálint Lakatos¹, Márton Tokodi¹, Federico Asch⁴, Karima Addetia³, Victor Mor-Avi³, Prof. Béla Merkely¹, Denisa Muraru⁵, Prof. Luigi P. Badano⁵, Prof. Roberto M. Lang³, Attila Kovács¹
1: Semmelweis University, Heart and Vascular Center
2: Argus Cognitive, Inc., Hanover, NH, USA
3: The University of Chicago, Noninvasive Cardiac Imaging Laboratory
4: MedStar Health Research Institute
5: University of Milano-Bicocca, Department of Medicine and Surgery

Text of the abstract

While pre-defined reference shapes have been used to assess morphological changes in the left ventricle, standardized methods for evaluating right ventricular (RV) remodeling are lacking. This study aimed to develop and test a new 3D echocardiography (3DE)-based method for quantifying RV shape in a large cohort of healthy individuals and across various disease states.
3DE-derived RV mesh models were reconstructed in 1043 healthy subjects from the World Alliance of Societies of Echocardiography (WASE) study and in 581 patients with severe aortic stenosis, heart failure (HF) with reduced ejection fraction (HFrEF), post-heart transplantation, severe primary mitral regurgitation (MR), atrial secondary tricuspid regurgitation (A-STR), tetralogy of Fallot (TOF), and pulmonary hypertension (PH). To assess global RV shape, hemi-sphericity volume ratio (HSVR) and hemi-conicity angle (HCA) were calculated, where a higher HSVR and a more acute HCA reflect more spherical and conical shapes, respectively. In the A-STR group, we assessed the associations between shape metrics and adverse clinical outcomes, defined as the composite of HF hospitalization and all-cause death.
In the WASE population, females had more spherical RVs, whereas males had more conical RVs (P=0.028). Considering age, younger females had more conical RVs, while older individuals in both sexes showed spherical remodeling (P<0.05). Comparing disease groups with WASE controls, MR, HFrEF, and A-STR patients had more spherical RVs (all P<0.001), while PH and TOF patients showed conical remodeling (both P<0.001). In the A-STR cohort, over a median follow-up of 1.4 years, 35 patients (21%) met the endpoint. In univariable Cox regression analyses, both HSVR [HR 0.34 (95% CI 0.15–0.78), P=0.011] and HCA [HR 0.96 (95% CI 0.92–0.99), P=0.014] were significant predictors of the endpoint, indicating that a more conical remodeling was associated with worse clinical outcomes.
The proposed 3DE-based method comprehensively characterizes RV geometry, demonstrating demographic variation in healthy individuals and disease-specific alterations in patients, with important prognostic implications.
Supported by the 2025-2.1.1-EKÖP-2025-00014 (EKÖP-2025-683) University Research Scholarship Programme of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.