Idiopathic Outflow Tract Tachycardias

Background:Echocardiographic right ventricular (RV) function assessment is difficult and still a gray area despite rapid advancement of imaging modalities. The aim of this study is to assess the role of echocardiographic RV outflow tract (RVOT) function in the form of RVOT fractional shortening (RVOT FS) and RVOT systolic excursion (RVOT SE) for the assessment of RV function.Methods:We studied ninety individuals divided equally into two groups. The control group included 45 normal healthy individuals and age-matched patient group included 45 patients with RV dysfunction which was defined by tricuspid annular plane systolic excursion (TAPSE) <16 mm and RV fractional area change (RV FAC) ≤35%. Echocardiography was performed to measure RVOT FS and RVOT SE and correlate them with other parameters of RV function including TAPSE, RV FAC, peak systolic velocity of the lateral tricuspid annulus (S’) using pulsed tissue Doppler, and pulmonary acceleration time (PAcT).Results:RVOT FS showed positive correlation with TAPSE (r = 0.75, P = 0.02), RV FAC (r = 0.45, P = 0.003), and PAcT (r = 0.39, P = 0.00) and negative correlation with left atrial dimensions (LADs) (r = −0.359, P = 0.017) and left ventricular end-diastolic dimensions (r = −0.304, P = 0.042). RVOT FS <32% was 93% sensitive and 98% specific to identify patients with impaired RV function. However, RVOT SE showed weak correlation with echocardiographic RV parameters. RVOT SE <5 mm was 80% sensitive and 76% specific to identify patients with impaired RV function.Conclusion:RVOT FS is a simple valuable parameter that can be used for the assessment of RV function. However, RVOT SE is less accurate than RVOT FS in RV function assessment.

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“…[ 7 10 ] Surgeons frequently estimate RV function during surgery by looking at the RVOT contraction. [ 12 13 ]…”

Section: Discussionmentioning

confidence: 99%

Right ventricular outflow tract systolic excursion and fractional shortening: Can these echocardiographic parameters be used for the assessment of right ventricular function?

Allam

Onsy

Ghalib

2017

J Cardiovasc Echography

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“…There have been several reports on the application of 12‐lead standard ECG findings for localization of OT‐VT. Table 4 summarizes the findings of these studies 12 …”

Section: Discussionmentioning

confidence: 99%

Effect of Limb Lead Electrodes Location on ECG and Localization of Idiopathic Outflow Tract Tachycardia: A Prospective Study

Arya

Frogner

Wetzel

et al. 2011

Cardiovasc electrophysiol

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“…This component has a smooth surface and a minute contribution to RV output volume, and is the last cardiac structure to be activated, at end systole [19]. This region is particularly important in patients with congenital heart disease [20] and arrhythmias such as the idiopathic outflow tachycardia [21], as well as for the diagnosis of arrhythmogenic right ventricle dysplasia (ARVD), for which the left parasternal long-axis view is usually preferred [22]. All in all, each region of the RV (Figure 1) is essential in patients with cardiopulmonary disorders and should be analysed in correlation with segmental coronary vascularisation [18,23].…”

Section: Anatomy and Physiology Of The Right Ventriclementioning

confidence: 99%

Right Chambers Quantification in Clinical Practice: Echocardiography Compared with Cardiac Magnetic Resonance Imaging

Agoşton-Coldea¹,

Lupu²

2013

Hot Topics in Echocardiography

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Hot Topics in Echocardiography 12mechanic activity which consists of inward, longitudinal and circumferential traction the systolic function is mainly determined by the longitudinal contraction which causes the shortening of the ventricle, with equal contribution from the interventricular septum and the free wall [ ]. Several factors contribute to RV global function, namely the preload, afterload and contractility. The preload is dependant on the volume status, the tricuspid valve gradient and the venous return from the vena cava. The afterload is determined by the resistance opposed by the pulmonary valve, the pulsatile flow reflected from the main pulmonary artery, the impedance of the proximal pulmonary artery and arterioles [ ]. Pulmonary vascular resistance may not, therefore, be used to assess RV total afterload, particularly in patients with pulmonary hypertension [ ]. Due to its thin free wall and high compliance, the RV can easily adapt to increased preload by dilatation, which can be well tolerated for a long time, although it eventually leads to RV failure. "y contrast, elevated afterload is poorly tolerated from an early stage, as the RV has little capacity for compensatory hypertrophy, which is quickly followed by increased stiffness and chamber dilatation [ ]. In clinical practice, changes in preload and afterload alter RV contraction. Other factors that may impair RV systolic function include abnormal variations of the heart rate, pharmacological agents, or ventricular interdependence [ ]. Ventricular interdependence refers to the fact that the shape, size and compliance of one ventricle may influence the shape, size or pressures in the other ventricle, an essential concept for understanding the pathophysiology of RV dysfunction [ ].

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Idiopathic Outflow Tract Tachycardias

Cited by 18 publications

References 50 publications

Right ventricular outflow tract systolic excursion and fractional shortening: Can these echocardiographic parameters be used for the assessment of right ventricular function?

Right ventricular outflow tract systolic excursion and fractional shortening: Can these echocardiographic parameters be used for the assessment of right ventricular function?

Effect of Limb Lead Electrodes Location on ECG and Localization of Idiopathic Outflow Tract Tachycardia: A Prospective Study

Right Chambers Quantification in Clinical Practice: Echocardiography Compared with Cardiac Magnetic Resonance Imaging

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