Three-dimensional right ventricular shape and strain in congenital heart disease patients with right ventricular chronic volume loading

2020 ◽  
Author(s):  
Pamela Moceri ◽  
Nicolas Duchateau ◽  
Stéphane Gillon ◽  
Lolita Jaunay ◽  
Delphine Baudouy ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Three Dimensional ◽  
Pulmonary Regurgitation ◽  
Strain Analysis ◽  
Local Analysis ◽  
Volume Loading ◽  
Rv Function

Abstract Aims Right ventricular (RV) function assessment is crucial in congenital heart disease patients, especially in atrial septal defect (ASD) and repaired Tetralogy of Fallot (TOF) patients with pulmonary regurgitation (PR). In this study, we aimed to analyse both 3D RV shape and deformation to better characterize RV function in ASD and TOF-PR. Methods and results We prospectively included 110 patients (≥16 years old) into this case–control study: 27 ASD patients, 28 with TOF, and 55 sex- and age-matched healthy controls. Endocardial tracking was performed on 3D transthoracic RV echocardiographic sequences and output RV meshes were post-processed to extract local curvature and deformation. Differences in shape and deformation patterns between subgroups were quantified both globally and locally. Curvature highlights differences in RV shape between controls and patients while ASD and TOF-PR patients are similar. Conversely, strain highlights differences between controls and TOF-PR patients while ASD and controls are similar [global area strain: −31.5 ± 5.8% (controls), −34.1 ± 7.9% (ASD), −24.8 ± 5.7% (TOF-PR), P < 0.001, similar significance for longitudinal and circumferential strains]. The regional and local analysis highlighted differences in particular in the RV free wall and the apical septum. Conclusion Chronic RV volume loading results in similar RV shape remodelling in both ASD and TOF patients while strain analysis demonstrated that RV strain is only reduced in the TOF group. This suggests a fundamentally different RV remodelling process between both conditions.

scholarly journals Transthoracic Echocardiography in Children and Young Adults with Congenital Heart Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-15 ◽  
Author(s):  
Martin Koestenberger
Keyword(s):  
Congenital Heart Disease ◽  
Young Adults ◽  
Heart Disease ◽  
Right Ventricular ◽  
Transthoracic Echocardiography ◽  
Congenital Heart ◽  
Doppler Imaging ◽  
Ventricular Performance ◽  
Children And Young Adults ◽  
Rv Function

Transthoracic echocardiography (TTE) is the first-line tool for diagnosis and followup of pediatric and young adult patients with congenital heart disease (CHD). Appropriate use of TTE can reduce the need for more invasive modalities, such as cardiac catheterization and cardiac magnetic resonance imaging. New echocardiographic techniques have emerged more recently: tissue Doppler imaging, tissue tracking (strain and strain rate), vector velocity imaging (VVI), myocardial performance index, myocardial acceleration during isovolumic acceleration (IVA), the ratio of systolic to diastolic duration (S/D ratio), and two dimensional measurements of systolic right ventricular (RV) function (e.g., tricuspid annular plane systolic excursion, TAPSE). These may become valuable indicators of ventricular performance, compliance, and disease progression. In addition, three-dimensional (3D) echocardiography when performed for the assessment of valvular function, device position, and ventricular volumes is being integrated into routine clinical care. In this paper, the potential use and limitations of these new echocardiographic techniques in patients with CHD are discussed. A particular focus is on the echocardiographic assessment of right ventricular (RV) function in conditions associated with increased right ventricular volume (e.g., pulmonary regurgitation after tetralogy of Fallot repair) or pressure (e.g., pulmonary hypertension) in children and young adults.

Volumetric analysis of the right ventricle in children with congenital heart defects: comparison of biplane angiography and transthoracic 3-dimensional echocardiography

1999 ◽  
Vol 9 (6) ◽  
pp. 577-584 ◽  
Author(s):  
A. Heusch ◽  
J. Rübo ◽  
O. N. Krogmann ◽  
M. Bourgeois
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Heart Defects ◽  
Three Dimensional ◽  
Ventricular Volume ◽  
Right Ventricular Volume ◽  
3 Dimensional ◽  
Dimensional Echocardiography

AbstractBackgroundThree-dimensional echocardiography is a non-invasive imaging technique. The fact that it permits volumetric analyses independently of geometrical assumptions makes it a putatively useful method for the precise measurement of the volumes of the irregularly shaped right ventricles in children. The aim of this study was to assess the feasibility of this method and its agreement with angiocardiography based estimates of right ventricular volume in children with congenital heart disease.MethodsWe studied 102 children with congenital heart disease. The angiocardiographic right ventricular volumetry was performed using a biplanar technique using Simpson's rule and corrected with Lange's correction factors. The echo data sets were registered trans-thoracically with a rotating transmitter. Volumes were calculated after manual planimetry by adding the volumes of the individual slices.ResultsCalculation of right ventricular volume echocardiographically was possible only in 34% of patients, mostly infants and toddlers. In comparison to angiocardiography, the measured volumes were 1.1 ±6.9 ml (19.5 ±34.1%) or 6.3±9.4ml (42.5±33.6%) smaller during systole or diastole, respectively. The limits of agreement were −12.5 and 13.6ml, or 12.45 and 25.15ml during systole or diastole, respectively. When plotted to a logarithmical scale, the correlation coefficients r2 were 0.70 for systolic and 0.79 for diastolic measurements.ConclusionTransthoracic 3-dimensional echocardiography with a rotating transmitter is feasible for volumetry only in small children. The volumes measured were significantly smaller than the ones calculated from the angiocardiographic images. The correlation between the two methods is moderate.

scholarly journals P987 Comprehensive systolic right ventricular longitudinal strain analysis in congenital heart disease patients with different right ventricular loading conditions

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Van Berendoncks ◽  
D J Bowen ◽  
J Mcghie ◽  
J A Cuypers ◽  
M Kauling ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Right Ventricular ◽  
Healthy Subjects ◽  
Congenital Heart ◽  
Function Analysis ◽  
Healthy Controls ◽  
Loading Conditions ◽  
Significant Difference ◽  
Rv Function

Abstract Background Right ventricular (RV) function is recognized as a prognostic factor in congenital heart disease (CHD). Speckle tracking analysis might reveal subclinical systolic dysfunction. Accurate assessment of global (GLS) and regional strain measurements of the RV remain challenging. We previously introduced a novel four-view approach with all RV walls visualized in their long axis from one apical view using 2D multi-plane-transthoracic echocardiographic (TTE) iRotate mode. Aims To extensive evaluate GLS of the entire RV using iRotate echocardiography in CHD patients with different RV loading conditions compared with healthy subjects. Methods and Results One-hundred forty-two CHD patients with different RV loading conditions were recruited from the outpatient clinic and compared with 89 age, gender and BSA matched healthy controls. CHD patients were divided in 5 groups: 42 patients with volume overloaded (VO)RV (at least moderate pulmonary or tricuspid regurgitation (TR) and/or an atrium septum defect), 16 patients with pressure overloaded (PO) RV (defined as TR velocity > 2.8 m/s), 34 patients who met both criteria for volume and pressure overloaded RV (P + VO), 30 patients with systemic RV and 27 with normal RV loading conditions. TAPSE and Fractional area change (FAC%) were significantly lower in all CHD subgroups vs healthy controls (p < 0.05). Within the CHD group, TAPSE, FAC% and TDI S` did not differentiate systemic RV from PO RV, whereas RV function was significantly better in RV VO and RV VO + PO compared with systemic RV. GLS was significantly lower in patients with CHD compared with healthy subjects. Within the CHD groups, GLS values of systemic RV were lower (p < 0.05), but no significant difference could be observed between the other subpulmonic RV loading conditions (Figure). Conclusion Comprehensive RV function analysis reveals decreased RV function in all CHD subgroups compared with healthy subjects. GLS showed RV systolic function to be the worst in the systemic RV but however could not differentiate between subpulmonic RV groups confirming the load independent functional analysis capacity of GLS. Abstract P987 Figure.

P2740Quantitative assessment of the entire right ventricle from one acoustic window: an attractive approach in patients with congenital heart disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A M Van Berendoncks ◽  
D J Bowen ◽  
J McGhie ◽  
J A Cuypers ◽  
M Kauling ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Right Ventricular ◽  
Healthy Subjects ◽  
Congenital Heart ◽  
Doppler Imaging ◽  
P Value ◽  
Limited Region ◽  
Coronal View ◽  
Rv Function

Abstract Background Right ventricular (RV) function is recognized as a prognostic factor in congenital heart disease (CHD). The accuracy of established parameters as tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RVFAC) and tissue Doppler imaging (TDI S') are limited as the parameters reflect only a limited region of the RV. We previously introduced a novel four-view approach with different RV walls visualized in their long axis from one apical view using 2D-transthoracic echocardiographic (TTE) iRotate mode. Aims To extensive evaluate the entire RV function using iRotate echocardiography in a whole spectrum of CHD patients with abnormally loaded RV; both feasibility and RV echocardiographic parameters as comparison with healthy subjects is evaluated. Methods and results One hundred and forty-two CHD patients with abnormally loaded RV and 89 healthy subjects were included. All subjects underwent complete TTE with evaluation of TAPSE, TDI S' and peak systolic global longitudinal RV strain (RV-GLS) from the RV walls using the four-view iRotate model. The feasibility of TAPSE and RV S' ranged between 94% and 100%. The feasibility of RV-GLS in CHD was 98%, 69%, 87% and 72% respectively in the lateral, anterior, inferior and inferior coronal view walls. With the exception of RV S' in the inferior coronal view, all parameters were significantly lower in the CHD vs healthy subjects (p<0.001) (Table). i-Rotate RV wall GLS (%) RV wall GLS (%) Measurement Feasibility Congenital (n=142) Controls (n=89) P-value Lateral 97.9 −17.6±5.0 −25.4±4.5 <0.001 Anterior 69.0 −15.9±4.9* −24.2±4.5 <0.001 Inferior 88.7 −17.2±4.7 −23.3±4.4 <0.001 Inferior coronal view 72.5 −15.1±4.5* ** −20.8±5.2 <0.001 Data expressed as mean ± SD or %. p<0.05 for *Lateral vs Anterior and vs Inferior CV; **Inferior vs Inferior CV. Conclusion The feasibility of all RV parameters in the four-axis iRotate model is excellent in CHD and represents a reproducible, easily applicable and complete RV assessment in daily practice. RV function is significantly decreased in the CHD group using both load dependent and independent parameters. Complete RV strain analysis reveals regional differences in patients with CHD.

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