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Background  There is today no established approach to estimate right ventricular ejection fraction (RVEF) using 2D transthoracic echocardiography (TTE). The aim of this study was to evaluate a new method for RVEF calculations using 2D TTE and compare the results with cardiac magnetic resonance (CMR) imaging and tricuspid annular plane systolic excursion (TAPSE).    Methods  A total of 37 subjects, 25 retrospectively included patients and twelve healthy volunteers, were included to give a wide range of RVEF. The right ventricle (RV) was modeled as a part of an ellipsoid enabling calculation of the RV volume by combining three distance measurements. RVEF calculated according to the model, RVEF TTE , were compared with reference CMR-derived RVEF, RVEF CMR . Further, TAPSE was measured in the TTE images and the correlations were calculated between RVEF TTE , TAPSE and RVEF CMR .    Results  The mean values were RVEF CMR  = 43 ± 12% (range 20–66%) and RVEF TTE  = 50 ± 9% (range 34–65%). There was a high correlation ( r =  0.80,  p <  0.001) between RVEF TTE  and RVEF CMR . Bland-Altman analysis showed a mean difference between RVEF CMR  and RVEF TTE  of 6 percentage points (ppt) with limits of agreement from −11 to 23 ppt. The mean value for TAPSE was 19 ± 5 mm and the correlation between TAPSE and RVEF CMR  was moderate ( r =  0.54,  p <  0.001). The correlation between RVEF TTE  and RVEF CMR  was significantly higher ( p <  0.05) than the correlation between TAPSE and RVEF CMR .    Conclusions  The ellipsoid model shows promise for RVEF calculations using 2D TTE for a wide range of RVEF, providing RVEF estimates that were significantly better correlated to RVEF obtained from CMR compared to TAPSE.    Electronic supplementary material  The online version of this article (doi:10.1186/s12947-017-0096-5) contains supplementary material, which is available to authorized users.

Right ventricular ejection fraction measurements using two-dimensional transthoracic echocardiography by applying an ellipsoid model