From simple measurement to a complex form: right ventricular volumetry using 2D-echocardiography - a retrospective cohort study

Sep 30, 2026

Assessment of right ventricular volume is crucial for monitoring patients with congenital heart defects, yet right ventricular complex geometry makes 2D echocardiography difficult and often leads to MRI use. MRI is limited by lack of bedside capability, time burden, and frequent need for sedation in pediatric congenital heart patients. This study develops a reliable, simple 2D echocardiography method to calculate right ventricular volume and validate it against MRI.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Methods and results

Study views and models

Comparison with MRI

Conclusion

Lay summary

Graphical Abstract

Introduction

European Heart Journal-Imaging Methods and Practice (2026) 4, qyaf160 [https://doi.org/10.1093/ehjimp/qyaf160](https://doi.org/10.1093/ehjimp/qyaf160) ORIGINAL ARTICLE Echocardiography From simple measurement to a complex form: right ventricular volumetry using 2D-echocardiography—a retrospective cohort study Raphael Seiler 1,2,*, Felix Günther3, Alexandra Hinke4, Florian Groß1, Teresa Lerach1, Jan Brüning5, Robert Dragendorf4, Felix Berger1,2, Titus Kühne1,5, Alexander Bobenko 6, and Stanislav Ovrutskiy1 1Department of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, Berlin 13353, Germany 2DZHK (German Centre for Cardiovascular Research), partner site Berlin, Potsdamer Straße 58 10785 Berlin, Germany 3Institut für Differentialgeometrie, Leibniz Universität Hannover, Welfengarten 1, Hannover 30167, Germany 4Charité -Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, Berlin 10117, Germany 5Institut für Kardiovaskuläre Computer-Assistierte Medizin, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, Berlin 13353, Germany 6Institut für Mathematik, MA 8-3, Technische Universität Berlin, Straße des 17. Juni, Berlin 10623, Germany Received 27 July 2025; accepted after revision 16 December 2025; online publish-ahead-of-print 18 December 2025 Abstract Aims Assessment of right ventricular volume is crucial for monitoring patients with congenital heart defects. However, due to the right ventricle’s complex geometry, 2D echocardiography is challenging and MRI is commonly used to evaluate right ventricular volume. However, MRI has several limitations: it lacks bedside imaging, is time-consuming, and often requires sedation in patients with congenital heart defects. Therefore, we aimed to develop a reliable and simple method for calculating right ventricular volume using 2D echocardiography. | . .
Methods and results | . .
Standard apical 4-chamber and parasternal short-axis views were obtained using 2D echocardiography in 40 congenital heart defects patients. Right ventricular volumes were calculated using an ellipsoidal shell model, a truncated cone model and a novel approach based on a cone model: VRV = ~~23~~ (ASAX~~ ~~+~~81~~π~~d ~~T2TV~~ ~~)A4CH~~ ~~ . The results were compared with right ventricular volumes obtained via MRI. The proposed cone-based model demonstrated excellent correlation to right ventricular volumes obtained by MRI (systolic: ICC = 0.98 (95% CI 0.95–0.99)/diastolic: ICC = 0.96 (95% CI 0.92–0.98)) . The mean difference from MRI-measured systolic volume was 0.1 mL (SD ± 13.3) and from diastolic volume 5.2 mL (SD ± 28.2) . Based on the root mean square error (RMSE) our cone model (RMSE 13.2 mL/28.4 mL systolic/diastolic) demonstrates significantly better predictive accuracy than the traditional ellipsoidal shell model (RMSE 20.8 mL/52.6 mL systolic/diastolic) and the truncated cone model (RMSE 25.1 mL/42.3 mL systolic/diastolic) . | | --- | --- | | .
Conclusion
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Our method shows excellent alignment with MRI data. It offers an accurate and rapid method for bedside assessment of right ventricular volume with 2D echocardiography, enhancing prompt and precise clinical decision-making.
- - | . . * Corresponding author. E-mail: [raphael.seiler@dhzc-charite.de](raphael.seiler@dhzc-charite.de) © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [reprints@oup.com](reprints@oup.com) for reprints a

FAQs

Why is measuring right ventricular volume challenging in congenital heart disease?

The right ventricle has complex geometry, making 2D echocardiography difficult. MRI is commonly used, but it has bedside, time, and sedation limitations.

How was right ventricular volume estimated in this study using 2D echocardiography?

Standard apical 4-chamber and parasternal short-axis views were obtained and right ventricular volumes were calculated using an ellipsoidal shell model, a truncated cone model, and a novel cone-based approach.

How did the proposed cone-based model perform compared with MRI?

The cone-based model showed excellent correlation with MRI-derived right ventricular volumes for both systolic and diastolic phases and achieved smaller mean differences and lower RMSE than the traditional models.

Sep 30, 2026

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