The role of echocardiography in the assessment of right ventricular systolic function in patients with transposition of the great arteries and atrial redirection

Iriart, Xavier; Horovitz, Alice; Geldorp, Irene E. van; Barnetche, Thomas; Léderlin, Mathieu; Guillebon, Maxime De; Réant, Patricia; Lafitte, Stéphane; Thambo, Jean-Benoît

doi:10.1016/j.acvd.2012.05.005

Cited by 32 publications

(23 citation statements)

References 21 publications

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“…studied 24 patients, and found a fair correlation between TAPSE and first‐pass radionuclide RVEF . Iriart and coworkers found no correlation between TAPSE and MRI‐RVEF in the 35 patients they studied, comparing a multivariable transthoracic echocardiographic analysis with MRI . But in the 18 patients studied by Lissin et al.…”

Section: Discussionmentioning

confidence: 96%

Tricuspid Annular Plane Systolic Excursion for the Assessment of Ventricular Function in Adults Operated on with Mustard Procedure for Complete Transposition of the Great Arteries

Bondanza

Calevo³

et al. 2013

Congenit Heart Dis

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Section: Discussionmentioning

confidence: 96%

Tricuspid Annular Plane Systolic Excursion for the Assessment of Ventricular Function in Adults Operated on with Mustard Procedure for Complete Transposition of the Great Arteries

Bondanza

Calevo³

et al. 2013

Congenit Heart Dis

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“…Studies of HLHS patients at other stages of palliation support the notion that the systemic RV adopts a circumferential contraction pattern, similar to the systemic left ventricle [11, 22]. Similarly, patients with d-transposition of the great arteries and systemic RVs after atrial redirection procedures (Mustard/Senning operations) also demonstrate a predominance of circumferential strain over longitudinal strain on speckle-tracking echocardiography of the RV [1, 7, 8, 23]. Values of TAPSE are diminished in this population as well and correlate poorly with RVEF [4, 8].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, decreased TAPSE in patients with systemic RVs after atrial redirection procedures for transposition of the great arteries has been described [7, 8]. However there are limited reports of TAPSE in patients with single, systemic RVs [9, 21], for whom a refined, noninvasive assessment of RV function on transthoracic echocardiogram (TTE) is of fundamental importance.…”

Section: Introductionmentioning

confidence: 99%

Tricuspid Annular Plane Systolic Excursion Does Not Correlate With Right Ventricular Ejection Fraction in Patients With Hypoplastic Left Heart Syndrome After Fontan Palliation

et al. 2014

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Tricuspid annular plane systolic excursion (TAPSE) reflects longitudinal myocardial shortening, the main component of right ventricular (RV) contraction in normal hearts. To date, TAPSE has not been extensively studied in patients with hypoplastic left heart syndrome (HLHS) and systemic RVs after Fontan palliation. This retrospective study investigated HLHS patients after Fontan with cardiac magnetic resonance (CMR) performed between 1 January 2010 and 1 August 2012 and transthoracic echocardiogram (TTE) performed within 6 months of CMR. The maximal apical displacement of the lateral tricuspid valve annulus was measured on CMR (using four-chamber cine images) and on TTE (using two-dimensional apical views). To create TTE–TAPSE z-scores, published reference data were used. Intra- and interobserver variability was tested with analysis of variance. Inter-technique agreement of TTE and CMR was tested with Bland–Altman analysis. In this study, 30 CMRs and TTEs from 29 patients were analyzed. The age at CMR was 14.1 ± 7.1 years, performed 11.9 ± 7.8 years after Fontan. For CMR–TAPSE, the intraclass correlation coefficients for inter- and intraobserver variability were 0.89 and 0.91, respectively. The TAPSE measurements were 0.57 ± 0.2 cm on CMR and 0.70 ± 0.2 cm on TTE (TTE–TAPSE z score, −8.7 ± 1.0). The mean difference in TAPSE between CMR and TTE was −0.13 cm [95 % confidence interval (CI) −0.21 to −0.05], with 95 %limits of agreement (−0.55 to 0.29 cm). The study showed no association between CMR–TAPSE and RVEF (R = 0.08; p = 0.67). In patients with HLHS after Fontan, TAPSE is reproducible on CMR and TTE, with good agreement between the two imaging methods. Diminished TAPSE suggests impaired longitudinal shortening in the systemic RV. However, TAPSE is not a surrogate for RVEF in this study population.

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“…Due to the complex geometry of the RV, quantitative 2D and Doppler measures by echocardiography are difficult to perform, correlate modestly at best with CMR estimates of ejection fraction and are not routinely used in clinical practice(7–9). Prior analysis of this SVR cohort has shown that standard echocardiographic measures of RV systolic and diastolic function are similar between shunt groups at 14 months(10).…”

Section: Introductionmentioning

confidence: 99%

Impact of Initial Norwood Shunt Type on Right Ventricular Deformation: The Single Ventricle Reconstruction Trial

Frommelt

Stelter

Campbell

et al. 2015

Journal of the American Society of Echocardiography

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Background The Single Ventricle Reconstruction (SVR) trial demonstrated a transplant-free survival advantage at 12 month follow up for patients with right-ventricle-pulmonary-artery shunt (RVPAS) at Norwood procedure versus modified Blalock-Taussig shunt (MBTS) but similar survival and decreased global right ventricular (RV) function on longer term follow-up. The impact of the required ventriculotomy for the RVPAS remains unknown. We compared echo-derived RV deformation indices after stage 2 procedure in survivors with single RV anomalies enrolled in the SVR trial. Methods Global and regional RV systolic longitudinal and circumferential strain and strain rate, ejection fraction, and short axis % fractional area change were all derived by speckle tracking echocardiography from protocol echocardiograms performed at 14.3±1.2 months. Student’s t-test or Wilcoxon rank sum test was used to compare groups. Results The cohort included 275 subjects (129 MBTS and 146 RVPAS). Longitudinal deformation could be quantified in 214 (78%) subjects and circumferential measures in 182 (66%) subjects. RV ejection fraction and % fractional area change did not differ between groups. There were no significant differences between groups for global or regional longitudinal deformation. Circumferential indices showed abnormalities in deformation in the RVPAS group with decreased global circumferential strain (p=0.05), strain rate (p=0.09) and anterior regional strain rate (p=0.07) that approached statistical significance. Conclusion RV myocardial deformation at 14 months, after stage 2 procedure, is not significantly altered by the type of initial shunt placed. However, abnormal trends were appreciated in circumferential deformation for the RVPAS group in the area of ventriculotomy that may represent early myocardial dysfunction. These data provide a basis for longer-term RV deformation assessment in survivors after Norwood procedure.

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The role of echocardiography in the assessment of right ventricular systolic function in patients with transposition of the great arteries and atrial redirection

Cited by 32 publications

References 21 publications

Tricuspid Annular Plane Systolic Excursion for the Assessment of Ventricular Function in Adults Operated on with Mustard Procedure for Complete Transposition of the Great Arteries

Tricuspid Annular Plane Systolic Excursion for the Assessment of Ventricular Function in Adults Operated on with Mustard Procedure for Complete Transposition of the Great Arteries

Tricuspid Annular Plane Systolic Excursion Does Not Correlate With Right Ventricular Ejection Fraction in Patients With Hypoplastic Left Heart Syndrome After Fontan Palliation

Impact of Initial Norwood Shunt Type on Right Ventricular Deformation: The Single Ventricle Reconstruction Trial

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