The Accuracy of Myocardial Performance Index in the Diagnosis of Right Ventricular Dysfunction After Surgical Correction of Tetralogy of Fallot: A Narrative Review

Abstract

Context: Tetralogy of Fallot (TOF) is one of the most important congenital heart diseases that its prognosis can be improved by surgery. However, Right Ventricular (RV) function may be disrupted because of pulmonary regurgitation and other preoperative and intraoperative factors. Access to a simple and reproducible diagnostic index of RV function is important. Echocardiographic index of Right Ventricular Myocardial Performance (RVMPI) has been used as a simple and noninvasive method for the assessment of RV function. Evidence Acquisition: This article review was conducted utilizing PubMed, Web of Science, Scopus and Google Scholar databases with the keywords of "Right Ventricle (RV)", "Myocardial Performance Index (MPI)", and "Tetralogy of Fallot (TOF) repair or correction". Results: RVMPI as a non-geometric echocardiographic index was compared with other echocardiographic indices, QRS duration in ECG, Cardiac Magnetic Resonance (CMR) findings, and exercise capacity in the pediatric and adult studies. Conclusions: This narrative review suggested that RVMPI, especially the tissue Doppler-derived has been used as a useful index of RV function in the follow-up of the repaired TOF patients. However, more research, including systematic reviews are necessary to determine the potential implication of RVMPI in the assessment of RV dysfunction.

Exercise Limitation in Children after Tetralogy of Fallot Repair Is Not related to Right Ventricular Dysfunction: Single Egyptian Center Experience

“…In our study, the QRS duration and corrected QT interval were prolonged in most of our patients (70%); however, both did not show statistically significant difference with the results of the 6-MWT (p=0.31, r=0.066, p=0.89, r= 0.169 respectively). Others reported a prolonged QRS and QT interval that were substantially longer in patients than in controls (17). QRS duration and QTc interval did not correspond with the distance walked in our study probably because they were prolonged secondary to the presence of RBBB.…”

“…A moderate to severe degree of PR is a well-known, prevalent consequence in TOF patients after surgical repair and may occur in more than half of patients (17)(18)(19). This PR results in right ventricle continuous dilation and stretching, which lead to several adverse effects later in life, including decreased exercise capacity, right and left ventricular malfunction, electrocardiographic anomalies, and perhaps most significantly, the development of ventricular arrhythmias and sudden cardiac arrest (17).…”