scholarly journals Multi-plane echocardiographic assessment of right ventricular function in adults with repaired Tetralogy of Fallot

2021 ◽  
Author(s):  
Daniel Bowen ◽  
An van Berendoncks ◽  
Jackie McGhie ◽  
Jolien Roos-Hesselink ◽  
Annemien van den Bosch
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Systolic Function ◽  
Peak Systolic Velocity ◽  
Control Group ◽  
Imaging Method ◽  
Repaired Tetralogy Of Fallot ◽  
Detailed Assessment ◽  
Echocardiographic Assessment ◽  
Rv Function

Abstract Background In patients with repaired Tetralogy of Fallot (ToF), detailed assessment of right ventricular (RV) function is important for management and timing of possible pulmonary valve re-intervention. The aim of this study was to evaluate RV function using two-dimensional multi-plane echocardiography (2D MPE), a novel four-wall imaging method obtained from one apical acoustic window utilising electronic plane rotation. Methods and Results In sixty-two ToF patients (aged - 28 [22, 39] years, 65 % male), systolic function of four different RV walls (lateral, anterior, inferior and inferior coronal) were evaluated using MPE. Tricuspid annular plane systolic excursion (TAPSE), tricuspid annular peak systolic velocity (RV-S’) and RV wall longitudinal strain (RV-LS) measurements were compared with those of matched healthy individuals. 2D MPE measurements were highly feasible across the four RV walls (93.5-100% for TAPSE/S’; 66.1-95.1% for RV-LS) and could be performed more reliably than 3D RV ejection fraction (RVEF - 56.5%). All functional values were significantly reduced when compared to the control group (p<0.001). Higher RV-LS values were seen in the lateral (-17.8±4.5%) and inferior (-17.8±4.2%) walls compared to the anterior (-15.9±3.8%) and inferior coronal (-15.1±3.9%) walls. 3D RVEF correlated strongest with RV-LS values from the lateral (r -0.50; p=0.002) and anterior walls (r -0.74; p<0.001) and furthermore the four-wall average (r -0.57; p=0.001). Conclusion 2D MPE evaluation of the RV is highly feasible in ToF patients. This novel method provides new insights into regional RV wall function, enabling a more comprehensive and quantitative approach to RV assessment in daily clinical practice.

scholarly journals Multi-plane echocardiographic assessment of right ventricular function in adults with repaired Tetralogy of Fallot

2021 ◽  
Author(s):  
Daniel J. Bowen ◽  
An M. van Berendoncks ◽  
Jackie S. McGhie ◽  
Jolien W. Roos-Hesselink ◽  
Annemien E. van den Bosch
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Systolic Function ◽  
Peak Systolic Velocity ◽  
Control Group ◽  
Imaging Method ◽  
Repaired Tetralogy Of Fallot ◽  
Detailed Assessment ◽  
Echocardiographic Assessment ◽  
Rv Function

AbstractIn patients with repaired Tetralogy of Fallot (ToF), detailed assessment of right ventricular (RV) function is important for management and timing of possible pulmonary valve re-intervention. The aim of this study was to evaluate RV function using two-dimensional multi-plane echocardiography (2D MPE), a novel four-wall imaging method obtained from one apical acoustic window utilising electronic plane rotation. In sixty-two ToF patients (aged - 28 [22, 39] years, 65% male), systolic function of four different RV walls (lateral, anterior, inferior and inferior coronal) were evaluated using MPE. Tricuspid annular plane systolic excursion (TAPSE), tricuspid annular peak systolic velocity (RV-S′) and RV wall longitudinal strain (RV-LS) measurements were compared with those of matched healthy individuals. 2D MPE measurements were highly feasible across the four RV walls (93.5–100% for TAPSE/S′; 66.1–95.1% for RVLS) and could be performed more reliably than 3D RV ejection fraction (RVEF − 56.5%). All functional values were significantly reduced when compared to the control group (p < 0.001). Higher RV-LS values were seen in the lateral (− 17.8 ± 4.5%) and inferior (− 17.8 ± 4.2%) walls compared to the anterior (− 15.9 ± 3.8%) and inferior coronal (− 15.1 ± 3.9%) walls. 3D RVEF correlated strongest with RV-LS values from the lateral (r − 0.50; p = 0.002) and anterior walls (r − 0.74; p < 0.001) and furthermore the four-wall average (r − 0.57; p = 0.001). 2D MPE evaluation of the RV is highly feasible in ToF patients. This novel method provides new insights into regional RV wall function, enabling a more comprehensive and quantitative approach to RV assessment in daily clinical practice.

Assessment of Right Ventricular Inefficiency Using Energy Transfer Ratio in Repaired Tetralogy of Fallot

2011 ◽  
Author(s):  
Namheon Lee ◽  
Ashish Das ◽  
William M. Gottliebson ◽  
Rupak K. Banerjee
Keyword(s):  
Energy Transfer ◽  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Main Pulmonary Artery ◽  
Pulmonary Regurgitation ◽  
Pulmonary Insufficiency ◽  
Control Group ◽  
Stroke Work ◽  
Transfer Ratio ◽  
Repaired Tetralogy Of Fallot

Pulmonary insufficiency (PI) induces pulmonary regurgitation and often leads to right ventricular (RV) enlargement and RV pressure overloading in repaired Tetralogy of Fallot (rTOF) patients. The appropriate timing of surgical treatments to renormalize RV function remains uncertain due to lack of suitable clinical diagnostic parameters. An energy transfer ratio (eMPA) between the net energy (Enet) transferred at main pulmonary artery (MPA) from RV and stroke work (SW) by RV was calculated using RV volume and pressure data for subjects in two study groups: the rTOF patient group (n = 7) and the control group (n = 7). Statistical analysis was performed to determine the difference of eMPA between the two groups. The mean eMPA for rTOF patients (0.64) was significantly lower (60.2%, p<0.05) than that of controls (1.61).

P3467Tricuspid annular isovolumic acceleration is more useful for the assessment of right ventricular systolic function in patients after repair of tetralogy of Fallot with pulmonary regurgitation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Toyono ◽  
S Yamada ◽  
M Aoki-Okazaki ◽  
T Takahashi
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Systolic Function ◽  
Pulmonary Regurgitation ◽  
Flow Reversal ◽  
Myocardial Velocity ◽  
Diastolic Flow ◽  
Isovolumic Contraction ◽  
Detrimental Impact ◽  
Rv Function

Abstract Introduction The detrimental impact of pulmonary regurgitation (PR) on right ventricular (RV) function of patients after repair of tetralogy of Fallot (TOF) is recognized. Although tricuspid annular isovolumic acceleration (IVA) is useful for the evaluation of RV function, it requires complicated measurement. Tricuspid annular plane systolic excursion (TAPSE) is measured easily and has also been validated as a marker of RV systolic function. Hypothesis We assessed the hypothesis that IVA has advantage to the stratification of the detrimental impact of PR on RV systolic function after TOF repair compared with TAPSE. Methods We prospectively examined patients after TOF repair. Patients <1 year after the repair, those with the history of sustained arrhythmia and those who required concomitant tricuspid and/or pulmonary valve surgery were excluded from the study. IVA was measured by dividing the myocardial velocity during isovolumic contraction by the time interval from the onset of the myocardial velocity during the isovolumic contraction to the time at the peak velocity of this wave. TAPSE was measured using M-mode echocardiography with the M-line passing through the lateral annulus of tricuspid valve in the apical 4-chamber plane. PR jets were evaluated in the parasternal short-axis plane. PR degree was assessed by the number of correspondence to the following conditions; 1) diastolic flow reversal in the main pulmonary artery, 2) diastolic flow reversal in the branch pulmonary arteries, 3) pressure half-time of PR signal <100 msec and 4) the ratio of the duration of the PR signal to the total duration of diastole <0.77. PR degree was graded from 0 to 4. Results Twenty-two patients were enrolled to the study. Age, female, period after the TOF repair and body height of the patients were 11±6 years, 55%, 9±5 years and 137±28 cm, respectively. In all the patients, IVA and TAPSE were 160±27 cm/sec2 and 12±2 mm, respectively. PR degrees were graded as 2, 3 and 4 in 4, 14 and 4 patients, respectively. By the Kruskal-Wallis test, only IVA showed a significant difference among the 3 PR degrees. Conclusion In conclusion, IVA can be a useful index for the stratification of RV function in patients after TOF repair with various degrees of PR.

scholarly journals Right Ventricular Strain in Repaired Tetralogy of Fallot After Pulmonary Valve Replacement With Reconstructed Radial Long-axis Cine Magnetic Resonance Images

2021 ◽  
Author(s):  
Masateru Kawakubo ◽  
Yuzo Yamasaki ◽  
Daisuke Toyomura ◽  
Kenichiro Yamamura ◽  
Ichiro Sakamoto ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Control Group ◽  
Short Axis ◽  
Short Axis Cine ◽  
Repaired Tetralogy Of Fallot ◽  
Before And After

Abstract Objectives: To investigate changes in right ventricular (RV) strain after pulmonary valve replacement (PVR) in repaired tetralogy of Fallot (TOF) by applying a novel postprocessing technique to conventional short-axis cine MRI to measure RV strains before and after PVR.Methods: Twenty-four patients with repaired TOF who underwent PVR and 16 healthy controls were enrolled. Global maximum and minimum principal strains (GPSmax, GPSmin) and global circumferential and longitudinal strains (GCS, GLS) were measured from short-axis cine images reconstructed radially along the long axis. Strain parameters before and after PVR were compared using paired t-tests. One-way ANOVA with Tukey post-hoc analysis was used for comparisons between the before and after PVR groups and the control group. Results: There were no differences in strain parameters before and after PVR. The GPSmax before PVR was lower than that in the control group (P=0.002). Before and after PVR, GCSs were higher and GLSs were lower than those in the control group (before and after GCSs: P=0.002 for both, before and after GLSs: P<0.0001 and P=0.0003). Conclusions: RV strains from radially reconstructed short-axis cine images revealed impaired myocardial motion after PVR. When compared to the control group, changes in GCS and GLS in TOF patients before and after PVR might be due to RV remodeling.

Abstract 15282: Right Ventricular Echocardiographic Analysis in the Critically Ill COVID-19 Population

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Akshar Jaglan ◽  
Sarah Roemer ◽  
Ana C Perez Moreno ◽  
Pedro D Salinas ◽  
Bijoy K Khandheria
Keyword(s):  
Right Ventricular ◽  
Critically Ill ◽  
Patient Population ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Peak Systolic Velocity ◽  
Point Of Care Ultrasound ◽  
Right Ventricular Free Wall ◽  
Icu Stay ◽  
Rv Function

Introduction: Coronavirus disease 2019 (COVID-19), has rapidly spread around the world and reached a pandemic level. The utility and benefit of echocardiographic analysis in this patient population has just started to be documented in the literature. We use this study to show the benefits of analyzing right ventricular (RV) function in this patient population. Methods: We assessed RV systolic function in 22 (mean age 63.5±4 years; 73% male) patients admitted to the ICU who tested positive for COVID-19. The transthoracic echocardiograms performed on the critically ill COVID-19 patients were focused studies done in supine position. Right ventricular free wall strain (RVFWS) was analyzed on proprietary software (EchoPac 202, GE Vingmed Ultrasound, Horten, Norway). RV systolic dysfunction was classified as tricuspid annulus peak systolic velocity (S’) <9.5 cm/s or RVFWS <-20%. Results: All 22 patients had either an S’ or RVFWS measurement; 20 of them had an observation for S’ and 16 had an observation for RVFWS. Median RVFWS among all patients was reduced at -18.5%. At the time of this writing, 14 of the 22 patients were being treated in the ICU or had died; median RVFWS in this subgroup was reduced at -17.5% and S’ at 12 cm/s. The 8 patients who transferred out of the ICU had a median RVFWS of -23.5 and S’ of 16 cm/s. Of the 10 patients classified as having RV dysfunction, 9 were due to RVFWS <-20% and 1 to S’ of < 9.5. Excluding patients who passed away, RV dysfunction was associated with a longer median ICU stay (21.5 days [interquartile range {IQR} 13-30] vs 9 days [IQR 5.5-16.5]; p=0.03). Conclusions: Of the 22 patients included in the study, currently 5 have died, 9 remain intubated in critical condition in the ICU, and 8 have been transferred to the medicine floor. In conclusion, focused, rather than point-of-care, ultrasound should be utilized to analyze RV function as there is clear evidence that RVFWS is correlated with longer ICU stay and poorer prognosis.

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