Echocardiographic measurement of right ventricular wall thickness in adults by anterior approach.

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Abstract
The best way to record the right ventricular wall by echocardiography was investigated in 40 consecutive adult subjects with normal hearts and with various congenital and acquired cardiac disorders. The right ventricular wall echo was recorded by an anterior approach from the left sternal border in the supine position with 2.25 and 5.0 MHz transducers; a subxiphoid approach with a 2.25 MHz transducer; and an anterior approach in an 80.degree. sitting position with 2.25 and 5.0 MHz transducers. The highest successful recording rate (80%) was obtained by an anterior approach in the supine position with a 5.0 MHz transducer. The recording success rate by an anterior approach in the sitting position was 70 and 37.5% with 5.0 and 2.25 MHz transducers, respectively, and the success rate by a subxiphoid approach was 50%. The normal range of the right ventricular wall thickness in 25 of another 32 normal adults examined expediantly was 2.4 .+-. 0.5 mm. When divided by body surface area, the normal right ventricular wall thickness index was 1.7 .+-. 0.2 mm/m2. The right ventricular wall thickness of another 21 patients with right ventricular overload ranged from 2.5-16 mm and seemed to correlate well with pulmonary arterial systolic pressure. The right ventricular wall thickness index had a better correlation with pulmonary arterial systolic pressure. A 5.0 MHz transducer is more suitable for the recording of the right ventricular wall by a standard approach than a 2.25 MHz transducer; this method would be useful for the diagnosis of right ventricular hypertrophy.