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Determination of right ventricular function with adjusted systolic to diastolic duration ratio after transannular patch repair of tetralogy of Fallot
Author(s) -
Arndt Andrew L.,
Madriago Erin,
Huang Jennifer,
Ronai Christina,
Silberbach Michael,
Broberg Craig S.,
Holmes Kathryn W.
Publication year - 2019
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14465
Subject(s) - tetralogy of fallot , cardiology , medicine , ejection fraction , ventricle , diastole , confidence interval , heart disease , heart failure , blood pressure
Abstract Background Early detection of right ventricular dysfunction after transannular patch for tetralogy of Fallot (TOF‐TAP) is essential for management. Objectives To evaluate echocardiographic metrics of ventricular function correlate with functional MRI measurements, in patients with TOF‐TAP. Methods A retrospective review of patients with TOF‐TAP between 2007 and 2017 who had an echocardiogram and MRI within six months were analyzed. Systolic to diastolic ratio (SD ratio) was measured from the tricuspid regurgitation and adjusted for heart rate. Tricuspid Annular Plane Systolic Excursion (TAPSE), Fractional Area Change (FAC), and shortening fraction (SF) were additionally measured. Echocardiographic measurements were correlated with MRI assessment of right ventricular ejection fraction (RVEF), left ventricular ejection fraction (LVEF), right ventricular end‐diastolic volume index (RVEDi), and right to left ventricle volume ratio (RV/LV). Results Of the 53 patients (mean age 12.8 years) that met inclusion criteria, 45 (85%) had available TR jets for SD ratio analysis. The HR adjusted SD ratio negatively correlated with RVEF ( r = −.359, P = .016), LVEF ( r = −.317, P = .038) and positively with RV/LV EDV ratio ( r = .347, P = .024). TAPSE, FAC, and SF measurements did not show significant correlation. Conclusion In patients with TOF‐TAP, there is a moderate negative correlation between heart rate adjusted SD ratio and MRI metrics of ventricular function, suggesting that decreased filling time is a marker for reduced right ventricular function. The SD ratio may be a useful echocardiographic tool for serial evaluation of in this population.