Investigation into the efficacy of fully automated three-dimensional echocardiographic quantification software (3D Auto RV) for assessing right ventricular systolic function in patients suffering from chronic mountain sickness.

OBJECTIVE: To evaluate the efficacy of fully automated three-dimensional echocardiographic right ventricular quantification software (3D Auto RV) for assessing right ventricular (RV) systolic function in patients with chronic mountain sickness (CMS). METHODS: In this prospective study (December 2023-March 2025), 32 CMS patients and 32 propensity score-matched controls (by age and sex) underwent 3D echocardiography. Conventional echocardiography measured main pulmonary artery diameter (MPA) and estimated pulmonary artery systolic pressure (PASP). The 3D Auto RV software was employed to obtain tricuspid annular plane systolic excursion (TAPSE), RV ejection fraction (RVEF), RV fractional area change (RVFAC), septal longitudinal strain (SLS), free-wall longitudinal strain (FWLS), and tissue Doppler S'. Intraclass correlation coefficients (ICC) were calculated for intra- and inter-observer agreement. RESULTS: The CMS group exhibited significantly lower RVEF, TAPSE, RVFAC, SLS, FWLS, and S', alongside higher PASP and MPA, compared with controls (all P < 0.001). Spearman correlation showed RVEF was positively correlated with SLS (r = 0.890, P < 0.01) and FWLS (r = 0.840, P < 0.01), and negatively correlated with PASP (r = -0.707, P < 0.01). ROC analysis revealed excellent diagnostic efficacy: RVEF (AUC 0.982, cut-off 46.7%), RVFAC (AUC 0.970, cut-off 36.75%), TAPSE (AUC 0.965, cut-off 16.2 mm), SLS (AUC 0.975, cut-off 21.8%), and FWLS (AUC 0.968, cut-off 19.85%). All parameters demonstrated good to excellent repeatability, with intra- and inter-observer ICCs exceeding 0.85. CONCLUSION: 3D Auto RV provides an accurate, reproducible, and feasible method for assessing RV systolic function in CMS patients, establishing a foundation for its routine clinical use.