Accuracy of right ventricular volumes and function determined by three-dimensional echocardiography in comparison with magnetic resonance imaging: a meta-analysis study.

BACKGROUND Determining right ventricular (RV) function is challenging because of the complex anatomy of the right ventricle. Three-dimensional echocardiography (3DE) has achieved better estimation, but underestimations of volumes and ejection fraction (EF) has often been reported, and no previous study has synthesized these data. The investigators performed a meta-analysis on the bias and examined the related factors. METHODS Studies comparing RV volumes and/or EF between 3DE and magnetic resonance imaging were eligible. A meta-analysis was performed to evaluate the systematic bias. The related bias was investigated using univariate and multivariate regression analysis. RESULTS Twenty-three studies including 807 subjects revealed underestimation of RV volumes (P < .00001) and EF (P = .03). Larger volumes and EF were associated with more underestimation. Older patient age was associated with overestimation of volumes and underestimation of EF. CONCLUSIONS This meta-analysis found underestimation of RV volumes and EF by 3DE and factors affecting the bias. These data provide a more detailed basis for improving the accuracy of 3DE for further clinical application.