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Assessment of regional and global right ventricular systolic function in children with repaired tetralogy of Fallot

Published online by Cambridge University Press:  22 February 2021

Elizabeth Caris Open the ORCID record for Elizabeth Caris [Opens in a new window]  and
Stacey Drant
Elizabeth Caris*
Affiliation:
Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA, USA
Stacey Drant
Affiliation:
Pediatric Cardiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
*
Author for correspondence: Elizabeth Caris, 4800 Sand Point Way NE, M/S RC.2.820. PO Box 5371, Seattle, WA 98105, USA. Fax: 206-987-3839. Email: [email protected]
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Abstract

Background:

Echo assessment of right ventricular function is difficult due to its complex geometry and regional differences in wall motion. In patients with repaired tetralogy of Fallot, cardiac MRI is the gold standard for assessment of right ventricular function. There is scant data regarding the correlation of echo measures of right ventricular function with cardiac MRI right ventricular function in the paediatric population.

Methods:

Echocardiographic measures of regional and global right ventricular function were reviewed in 56 patients with repaired tetralogy of Fallot and 27 patients with structurally normal hearts. These measures were compared to global right ventricular ejection fraction by cardiac MRI.

Results:

Despite having the same right ventricular ejection fraction by cardiac MRI as normal controls, patients with repaired tetralogy of Fallot had significantly worse global and regional echocardiographic measures of right ventricular function. Right ventricular fractional area change and fractional shortening of the right ventricular outflow tract correlated best with global right ventricular function by MRI. Incorporation of these measures into a regression model allowed accurate prediction of global right ventricular function by cardiac MRI.

Conclusion:

Children with repaired tetralogy of Fallot have abnormal regional and global right ventricular function compared to patients with normal hearts. Despite the presence of patch material, the right ventricular outflow tract significantly contributes to global right ventricular function by cardiac MRI. When incorporated into a model that includes regional and global echocardiographic measures of right ventricular function, right ventricular outflow tract fractional shortening helps predict global right ventricular function by MRI.

Keywords

Tetralogy of Fallotechocardiographycardiac MRI
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 10 , October 2021 , pp. 1571 - 1575
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Haddad, F, Doyle, R, Murphy, DJ, Hunt, SA. Right ventricular function in cardiovascular disease, part II. Circulation 2008; 117: 1717–1731.CrossRefGoogle ScholarPubMed
Rudski, LG, Lai, WW, Afilalo, J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American society of echocardiography. J Am Soc Echocardiogr 2010; 23: 685–713.CrossRefGoogle ScholarPubMed
Lopez, L, Cohen, MS, Anderson, RH, et al. Unnatural history of the right ventricle in patients with congenitally malformed hearts. Cardiol Young 2010; 20 (Suppl 3): 107–112.CrossRefGoogle ScholarPubMed
Srinivasan, C, Sachdeva, R, Murrow, W. Limitations of standard echocardio- graphic methods for quantification. J Ultrasound Med 2011; 30: 487–493.CrossRefGoogle Scholar
Li, J, Luo, S, Liu, F, An, Q. Systolic function of right ventricular outflow tract is a better predictor to exercise performance after pulmonary valve replacement in tetralogy of Fallot. Pediatr Cardiol 2017; 38(8): 1556–1561.CrossRefGoogle Scholar
Luo, S, Li, J, Yang, D, Zhou, Y, An, Q, Chen, Y. Right ventricular outflow tract systolic function correlates with exercise capacity in patients with severe right ventricle dilatation after repair of tetralogy of Fallot. Interact Cardiovasc Thorac Surg 2017; 24: 755–761.CrossRefGoogle ScholarPubMed
Valente, AM, Ko, HH, Cook, S, et al. Multimodality imaging guidelines for patients with repaired tetralogy of Fallot: a report from the American Society of echocardiography. J Am Soc Echocardiogr 2014; 27: 111–141.CrossRefGoogle Scholar
Kutty, S, Zhou, J, Gauvreau, K, et al. 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.CrossRefGoogle ScholarPubMed
Greutmann, M, Tobler, D, Biaggi, P, et al. Echocardiography for assessment of regional and global right ventricular systolic function in adults with repaired tetralogy of Fallot. Int J Cardiol 2012; 157: 53–58.CrossRefGoogle ScholarPubMed
Hamilton-Craig, CR, Stedman, K, Maxwell, R, et al. Accuracy of quantitative echocardiographic measures of right ventricular function as compared to cardiovascular magnetic resonance. IJC Hear Vasc 2016; 12: 38–44.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Davlouros, PA, Kilner, PJ, Hornung, TS, et al. Right ventricular function in adults with repaired tetralogy of Fallot assessed with cardiovascular magnetic resonance imaging: detrimental role of right ventricular outflow aneurysms or akinesia and adverse right-to-left ventricular interaction. J Am Coll Cardiol 2002; 40(11): 2044–2052.CrossRefGoogle ScholarPubMed
Morcos, P, Vick, GW, 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.CrossRefGoogle ScholarPubMed
Kawel-Boehm, N, Maceira, A, Valsangiacomo-Buechel, ER, et al. Normal values for cardiovascular magnetic resonance in adults and children. J Cardiovasc Magn Reson 2015; 17: 1–33.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed