Echocardiographic right ventricle longitudinal contraction indices cannot predict ejection fraction in post-operative Fallot children

Bonnemains, Laurent; Stos, Bertrand; Vaugrenard, Thibaud; Marie, Pierre-Yves; Odille, Freddy; Boudjemline, Younès

doi:10.1093/ejechocard/jer263

Cited by 38 publications

(28 citation statements)

References 30 publications

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“…However, a smaller study of TOF in an age group comparable with ours also found that TAPSE failed to predict RVEF on CMR. 11 In agreement with this smaller study, our data suggest that TAPSE is not discriminative, sensitive, or specific for identifying patients with TOF with reduced RVEFs.…”

Section: Discussionsupporting

confidence: 83%

“…These findings are in contrast to those of some studies but in agreement with the results of others. 11,12,27 Van der Zwaan et al 27 studied patients with heart failure and affected right and/or left ventricles and found a modest correlation of TAPSE with RVEF on CMR (correlation coefficient = 0.4). In TOF, Koestenberger et al 12 found a modest correlation (correlation coefficient = 0.47) between TAPSE and RVEF measured on CMR.…”

Section: Discussionmentioning

confidence: 99%

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Tricuspid Annular Plane Systolic Excursion in the Assessment of Right Ventricular Function in Children and Adolescents after Repair of Tetralogy of Fallot

Mercer‐Rosa

Parnell

Forfia

et al. 2013

Journal of the American Society of Echocardiography

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Background Assessing right ventricular (RV) performance is essential for patients with tetralogy of Fallot (TOF). The aim of this study was to investigate the reliability and validity of tricuspid annular plane systolic excursion (TAPSE) against cardiac magnetic resonance imaging measures and cardiopulmonary exercise testing. Methods A retrospective study was performed in 125 outpatients with repaired TOF with available protocoldriven echocardiography, cardiac magnetic resonance imaging, and exercise stress testing obtained as part of a cross-sectional study. TAPSE was measured on the two-dimensional apical four-chamber view on echocardiography by two readers. Multivariate linear regression was used to examine the association between TAPSE and measures of RV function and exercise capacity. Results The mean age was 12.6 ± 3.3 years, 41 patients (33%) were female, and 104 (83%) were white. TAPSE averaged 1.6 ± 0.37 cm, with an interreader intraclass correlation coefficient of 0.78 (n = 18). TAPSE was significantly associated with cardiac magnetic resonance–based RV stroke volume after adjustment for gender and body surface area (β = 13.8; 95% confidence interval, 2.25–25.30; P = .02). TAPSE was not associated with cardiac magnetic resonance–based RV ejection fraction (P = .77). On exercise testing, TAPSE was not associated with peak oxygen consumption, percentage of predicted oxygen consumption, oxygen pulse, or the ventilatory equivalent for carbon dioxide in patients with maximal exercise stress testing (n = 73 [58%]). Conclusions TAPSE is reproducibly measured by echocardiography in patients with TOF. It is not associated with RV ejection fraction or exercise performance, and its association with RV stroke volume may be confounded by body size. On the basis of these results, TAPSE is not representative of global RV performance in patients with TOF.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Tricuspid Annular Plane Systolic Excursion in the Assessment of Right Ventricular Function in Children and Adolescents after Repair of Tetralogy of Fallot

Mercer‐Rosa

Parnell

Forfia

et al. 2013

Journal of the American Society of Echocardiography

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“…As well, the RV can be especially difficult to image reliably in this population because of its dilation and retrosternal location. 26,27 CMR is not hindered by these drawbacks, typically provides high-quality and reproducible imaging data sets, and has become the modality of choice in the assessment of ventricular size and function in many forms of adult congenital heart disease, including TOF. 28,29 For these reasons, we used a CMR-based approach in this study.…”

Section: Discussionmentioning

confidence: 99%

Impact of Transcatheter Pulmonary Valve Replacement on Biventricular Strain and Synchrony Assessed by Cardiac Magnetic Resonance Feature Tracking

Harrild

Marcus

Hasan

et al. 2013

Circ: Cardiovascular Interventions

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Background-Transcatheter pulmonary valve (TPV) replacement is an emerging therapy intended to restore pulmonary valve function in patients with right ventricular outflow tract conduit dysfunction; the impact of this technique on ventricular strain and synchrony is not known. Methods and Results-Cardiac magnetic resonance and ECG data acquired at 1 center as part of the US Melody TPV trial were analyzed. Biventricular strain and mechanical synchrony measurements were made based on short-axis and 4-chamber steady-state free precession images using feature tracking software. Post-versus pre-TPV replacement findings were compared for all patients (n=31) and subgroups with predominant pulmonary regurgitation (n=13) or stenosis (n=18). Most patients had tetralogy of Fallot (18/31). After TPV replacement, left ventricular (LV) circumferential strain increased for the whole cohort (P<0.001) and both subgroups (pulmonary regurgitation P=0.01; pulmonary stenosis P=0.02). LV longitudinal strain increased for the whole cohort (P=0.02) and pulmonary regurgitation subgroup (P=0.05); circumferential right ventricular strain increased for the pulmonary stenosis group only (P=0.05). LV longitudinal synchrony improved significantly in the pulmonary regurgitation group (maximum wall delay P=0.03; cross-correlation delay P=0.01). Electric measures of synchrony did not improve. Conclusions-In Harrild et al Impact of TPV Replacement 681are no reports of any kind of its impact on synchrony of the left ventricle (LV) or RV. The goal of the present study was to quantify the impact of TPV replacement on indices of RV and LV strain and synchrony in patients with dysfunctional RVOT conduits using high-quality CMR images. Methods Study DesignThis was a retrospective cohort study of patients undergoing placement of a Melody TPV in the setting of a dysfunctional RVOT conduit designed to investigate changes in ventricular mechanics based on CMR images before and after pulmonary valve implantation. This study was performed according to a protocol approved by the Committee for Clinical Investigations at Boston Children's Hospital, Boston, MA. PatientsPatients included in this study comprised a subset of the cohort enrolled at our center as part of the multicenter US Melody TPV investigational device exemption (IDE) trial. Briefly, the IDE trial was designed to investigate the safety, procedural success, and short-term effectiveness of Melody valve placement in patients with a biventricular circulation and a dysfunctional RVOT conduit. Study protocols and short-term outcomes have been previously reported. 4,5 As part of their participation in the trial, patients had clinical, ECG, and CMR data collected before and 6±2 months after TPV replacement. Patients were included in the present study if they had high-quality CMR images for analysis both pre-and post-TPV replacement performed between 2007 and 2010.Patients were first analyzed as an entire cohort, and then dichotomized into 2 groups: predominant pulmonary stenosis (PS; RVOT peak systolic e...

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“…24,28 The trabeculations were included in the RV area measurements to avoid underestimating the areas. 9,12,29 The RV endocardial areas were delineated for three consecutive cardiac cycles and the mean of the three values were used to compute FAC. 29 The RV FAC was automatically calculated from the EchoPAC™ software analysis as follows: 100 x [RV end-diastolic area (cm 2 ) – RV end-systolic area (cm 2 )]/ RV end-diastolic area (cm 2 ), (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

“…24,28 Care was taken to include the trabeculations in the measurements of the area by tracing the RVEDA and RVESA between RV trabeculations and the compact layer of the ventricle. 9,12,29 The RVESA and RVEDA were measured at the frames just before tricuspid valve opening and just after the valve closure, respectively. 5,10 Fractional area of change = 100 x ((RVEDA (cm 2 ) - RVESA (cm 2 )) / RVEDA (cm 2 ).…”

Section: Figurementioning

confidence: 99%

Right Ventricular Function in Preterm and Term Neonates: Reference Values for Right Ventricle Areas and Fractional Area of Change

Levy

Dioneda

Holland

et al. 2015

Journal of the American Society of Echocardiography

101

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Background Right Ventricle fractional area of change (RV FAC) is a quantitative two- dimensional echocardiographic measurement of RV function. RV FAC expresses the percentage change in the RV chamber area between end-diastole (RVEDA) to end-systole (RVESA). The objectives of this study were to determine the maturational (age- and weight- related) changes of RV FAC and RV areas and to establish reference values in healthy preterm and term neonates. Methods A prospective longitudinal study was conducted in 115 preterm infants (23-28 weeks gestational age at birth, 500-1500 gram). RV FAC was measured at 24 hours of age, 72 hours of age, 32 weeks and 36 weeks postmenstrual age (PMA). The maturational patterns of RVEDA, RVESA, and RV FAC were compared to 60 healthy full term infants in a cross sectional study (> 37 weeks, 3.5 +/− 1 kg), who received echocardiograms at birth (n=25) and one month of age (n=35). RVEDA and RVESA were traced in the RV focused apical 4-chamber view, and FAC was calculated using the formula: 100 * [(RVEDA – RVESA)/RVEDA)]. Premature infants that developed chronic lung disease or had a clinically and hemodynamically significant PDA were excluded (n=55) from the reference values. Intra- and inter- observer reproducibility analysis was performed. Results RV FAC ranged from 26% at birth to 35% by 36 weeks PMA in preterm infants (n=60) and increased almost two times faster in the first month of age as compared to healthy term infants (n=60). Similarly, RVEDA and RVESA increased throughout maturation in both term and preterm infants. RV FAC and RV areas correlated with weight (r=0.81, p<0.001), but were independent of gestational age at birth (r=0.3, p=0.45). RVEDA and RVESA correlated with PMA in weeks (r=0.81, p<0.001). RV FAC trended lower in preterm infants with bronchopulmonary dysplasia (p=0.04), but did not correlate to size of PDA (p=0.56). There was no difference in RV FAC based on gender or need for mechanical ventilation. Conclusions This study establishes reference values of RV areas (RVEDA and RVESA) and RV fractional area of change (RV FAC) in healthy term and preterm infants and tracks their maturational changes during postnatal development. These measures increase from birth to 36 weeks PMA, and this is reflective of the postnatal cardiac growth as a contributor to the maturation of cardiac function These measures are also linearly associated with increasing weight throughout maturation. This study suggests that two-dimensional RV FAC can be used as a complementary modality to assess global RV systolic function in neonates and facilitates its incorporation into clinical pediatric and neonatal guidelines.

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Echocardiographic right ventricle longitudinal contraction indices cannot predict ejection fraction in post-operative Fallot children

Abstract: Three conventional echocardiographic indices based on RV longitudinal contraction failed to assess the EF in our population of post-operative tetralogy of Fallot patients.

Cited by 38 publications

References 30 publications

Tricuspid Annular Plane Systolic Excursion in the Assessment of Right Ventricular Function in Children and Adolescents after Repair of Tetralogy of Fallot

Tricuspid Annular Plane Systolic Excursion in the Assessment of Right Ventricular Function in Children and Adolescents after Repair of Tetralogy of Fallot

Impact of Transcatheter Pulmonary Valve Replacement on Biventricular Strain and Synchrony Assessed by Cardiac Magnetic Resonance Feature Tracking

Right Ventricular Function in Preterm and Term Neonates: Reference Values for Right Ventricle Areas and Fractional Area of Change

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