PhD Scientific Days 2025

Poster Session I. - T: Cardiovascular Medicine and Research

Decoding Right Ventricular Shape: A 3D Echocardiographic Study Across Health and Disease States

Name of the presenter

Ferencz Andrea

Institute/workplace of the presenter

Semmelweis University, Heart and Vascular Center, Budapest, Hungary

Authors

Dr. Andrea Ferencz¹, Dr. Martin Gruca², Janka Hatvani³, Bálint Magyar³, Ádám Szijártó¹, Dr. Juan Cotella², Dr. Bálint Lakatos¹, Dr. Márton Tokodi¹, Dr. Federico Asch⁴, Dr. Karima Addetia², Prof. Victor Mor-Avi², Prof. Béla Merkely¹, Dr. Denisa Muraru⁵, Prof. Luigi P. Badano⁵, Dr. Attila Kovács¹, Prof. Roberto M. Lang², Dr. Alexandra Fábián¹

1: Semmelweis University, Heart and Vascular Center, Budapest, Hungary
2: The University of Chicago, Noninvasive Cardiac Imaging Laboratory, Chicago, IL, USA
3: Argus Cognitive, Inc., Hanover, NH, USA
4: MedStar Health Research Institute, Washington, DC, USA
5: University of Milano-Bicocca, Department of Medicine and Surgery, Milan, Italy

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 3D echocardiography (3DE)-based method for quantifying RV sphericity and conicity 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 WASE study and in 415 patients with various disease states, including severe aortic stenosis (AS), heart failure (HF), post heart transplantation (HTX), severe mitral regurgitation (SMR), tetralogy of Fallot (TOF) and pulmonary hypertension (PH). To assess the RV’s global shape, reference hemi-sphere, and hemi-cone shapes were created using a dimension-adjusting method. The end-diastolic hemi-sphericity volume ratio (HSVR) and the hemi-conicity angle (HCA) were introduced and compared between populations by sex, age, race, and disease states. A higher HSVR reflects a more spherical shape, whereas a more acute HCA indicates a more conical shape.
In the WASE population, females presented with a more spherical RV; thus, males’ RVs were more conical (male vs female; HSVR: 1.13±0.32 vs 1.17±0.34, p=0.025; HCA: 72.8±7.7 vs 73.9±7.8°, p=0.028). When results were categorized by age and race, males aged 41-65 exhibited the most spherical RV (p<0.05). In females, those aged 18-40 had the most conical RV, while individuals over 65 years showed the most spherical RV (p<0.001). In terms of race, white males had the most spherical RV, while black males demonstrated the most conical RV (p<0.001). Comparing the disease cohorts, patients with SMR showed the most spherical RV (HSVR: 1.58±0.55, HCA: 82.0±8.4°), followed by HTX and HF (p<0.001). Notably, PH (HSVR: 0.97±0.30, HCA: 68.6±9.6°) and TOF patients showed conical RV remodelling (p<0.001).
The proposed 3DE method allowed for a unique assessment of the RV geometry, revealing characteristic differences across sexes, age groups and races in healthy individuals and patients with different diseases.
Supported by the 2024-2.1.1-EKÖP-2024-00004 (EKÖP-2024-110) University Research Scholarship Programme of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation fund and by the SE250+ Grant of Semmelweis University.