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Evaluation of tricuspid annular plane systolic excursion measured with cardiac MRI in children with tetralogy of Fallot

Published online by Cambridge University Press:  17 August 2015

Jonathan H. Soslow ,
Emem Usoro ,
Li Wang  and
David A. Parra
Jonathan H. Soslow*
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America
Emem Usoro
Affiliation:
Meharry Medical College, Nashville, TN 37208, United States of America
Li Wang
Affiliation:
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America
David A. Parra
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America
*
Correspondence to: J. H. Soslow, MD, MSCI, Vanderbilt University Medical Center, 2200 Children’s Way, Suite 5230, DOT, Nashville, TN 37232, United States of America. Tel: +615 322 7447; Fax: +615 322 2210; E-mail: [email protected]
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Abstract

Background

Aneurysmal dilation of the right ventricular outflow tract complicates assessment of right ventricular function in patients with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is commonly used to estimate ejection fraction. We hypothesised that tricuspid annular plane systolic excursion measured by cardiac MRI approximates global and segmental right ventricular function, specifically right ventricular sinus ejection fraction, in children with repaired tetralogy of Fallot.

Methods

Tricuspid annular plane systolic excursion was measured retrospectively on cardiac MRIs in 54 patients with repaired tetralogy of Fallot. Values were compared with right ventricular global, sinus, and infundibular ejection fractions. Tricuspid annular plane systolic excursion was indexed to body surface area, converted into a fractional value, and converted into published paediatric Z-scores.

Results

Tricuspid annular plane systolic excursion measurements had good agreement between observers. Right ventricular ejection fraction did not correlate with the absolute or indexed tricuspid annular plane systolic excursion and correlated weakly with fractional tricuspid annular plane systolic excursion (r=0.41 and p=0.002). Segmental right ventricular function did not appreciably improve correlation with any of the tricuspid annular plane systolic excursion measures. Paediatric Z-scores were unable to differentiate patients with normal and abnormal right ventricular function.

Conclusions

Tricuspid annular plane systolic excursion measured by cardiac MRI correlates poorly with global and segmental right ventricular ejection fraction in children with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is an unreliable approximation of right ventricular function in this patient population.

Keywords

Tricuspid annular plane systolic excursionright ventricular functiontetralogy of Fallotpaediatric cardiology
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 4 , April 2016 , pp. 718 - 724
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Copyright
© Cambridge University Press 2015 

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References

1. Geva, T, Powell, AJ, Crawford, EC, Chung, T, Colan, SD. Evaluation of regional differences in right ventricular systolic function by acoustic quantification echocardiography and cine magnetic resonance imaging. Circulation 1998; 98: 339–345.Google Scholar
2. Kutty, S, Zhou, J, Gauvreau, K, Trincado, C, Powell, AJ, Geva, T. Regional dysfunction of the right ventricular outflow tract reduces the accuracy of Doppler tissue imaging assessment of global right ventricular systolic function in patients with repaired tetralogy of Fallot. J Am Soc Echocardiogr 2011; 24: 637–643.Google Scholar
3. Kaul, S, Tei, C, Hopkins, JM, Shah, PM. Assessment of right ventricular function using two-dimensional echocardiography. Am Heart J 1984; 107: 526–531.CrossRefGoogle ScholarPubMed
4. Speiser, U, Hirschberger, M, Pilz, G, et al. Tricuspid annular plane systolic excursion assessed using MRI for semi-quantification of right ventricular ejection fraction. Br J Radiol 2012; 85: e716–e721.Google Scholar
5. Nijveldt, R, Germans, T, McCann, GP, Beek, AM, van Rossum, AC. Semi-quantitative assessment of right ventricular function in comparison to a 3D volumetric approach: a cardiovascular magnetic resonance study. Eur Radiol 2008; 18: 2399–2405.Google Scholar
6. Koestenberger, M, Ravekes, W, Nagel, B, et al. Longitudinal systolic ventricular interaction in pediatric and young adult patients with TOF: a cardiac magnetic resonance and M-mode echocardiographic study. Int J Cardiovasc Imaging 2013; 29: 1707–1715.CrossRefGoogle Scholar
7. Koestenberger, M, Nagel, B, Ravekes, W, et al. Systolic right ventricular function in pediatric and adolescent patients with tetralogy of Fallot: echocardiography versus magnetic resonance imaging. J Am Soc Echocardiogr 2011; 24: 45–52.Google Scholar
8. Mercer-Rosa, L, Parnell, A, Forfia, PR, Yang, W, Goldmuntz, E, Kawut, SM. Tricuspid annular plane systolic excursion in the assessment of right ventricular function in children and adolescents after repair of tetralogy of Fallot. J Am Soc Echocardiogr 2013; 26: 1322–1329.Google Scholar
9. Morcos, P, Vick, GW 3rd, Sahn, DJ, Jerosch-Herold, M, Shurman, A, Sheehan, FH. Correlation of right ventricular ejection fraction and tricuspid annular plane systolic excursion in tetralogy of Fallot by magnetic resonance imaging. Int J Cardiovasc Imaging 2009; 25: 263–270.Google Scholar
10. Bonnemains, L, Stos, B, Vaugrenard, T, Marie, PY, Odille, F, Boudjemline, Y. Echocardiographic right ventricle longitudinal contraction indices cannot predict ejection fraction in post-operative Fallot children. Eur Heart J Cardiovasc Imaging 2012; 13: 235–242.CrossRefGoogle ScholarPubMed
11. Schulz-Menger, J, Bluemke, DA, Bremerich, J, et al. Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) Board of Trustees Task Force on Standardized Post Processing. J Cardiovasc Magn Reson 2013; 15: 35.Google Scholar
12. Caudron, J, Fares, J, Vivier, PH, Lefebvre, V, Petitjean, C, Dacher, JN. Diagnostic accuracy and variability of three semi-quantitative methods for assessing right ventricular systolic function from cardiac MRI in patients with acquired heart disease. Eur Radiol 2011; 21: 2111–2120.Google Scholar
13. Koestenberger, M, Ravekes, W, Everett, AD, et al. Right ventricular function in infants, children and adolescents: reference values of the tricuspid annular plane systolic excursion (TAPSE) in 640 healthy patients and calculation of z score values. J Am Soc Echocardiogr 2009; 22: 715–719.CrossRefGoogle ScholarPubMed
14. Brown, SB, Raina, A, Katz, D, Szerlip, M, Wiegers, SE, Forfia, PR. Longitudinal shortening accounts for the majority of right ventricular contraction and improves after pulmonary vasodilator therapy in normal subjects and patients with pulmonary arterial hypertension. Chest 2011; 140: 27–33.Google Scholar
15. Kind, T, Mauritz, GJ, Marcus, JT, van de Veerdonk, M, Westerhof, N, Vonk-Noordegraaf, A. Right ventricular ejection fraction is better reflected by transverse rather than longitudinal wall motion in pulmonary hypertension. J Cardiovasc Magn Reson 2010; 12: 35.Google Scholar
16. Vogel, M, Sponring, J, Cullen, S, Deanfield, JE, Redington, AN. Regional wall motion and abnormalities of electrical depolarization and repolarization in patients after surgical repair of tetralogy of Fallot. Circulation 2001; 103: 1669–1673.Google Scholar
17. Lopez-Candales, A, Rajagopalan, N, Saxena, N, Gulyasy, B, Edelman, K, Bazaz, R. Right ventricular systolic function is not the sole determinant of tricuspid annular motion. Am J Cardiol 2006; 98: 973–977.CrossRefGoogle Scholar
18. Lamia, B, Teboul, JL, Monnet, X, Richard, C, Chemla, D. Relationship between the tricuspid annular plane systolic excursion and right and left ventricular function in critically ill patients. Intensive Care Med 2007; 33: 2143–2149.Google Scholar