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Improving the role of echocardiography in studying the right ventricle of repaired tetralogy of Fallot patients: comparison with cardiac magnetic resonance

  • Carolina D’Anna
  • Armando Caputi
  • Benedetta Natali
  • Benedetta Leonardi
  • Aurelio Secinaro
  • Gabriele Rinelli
  • Alessia Del Pasqua
  • Claudia Esposito
  • Adriano Carotti
  • Fabrizio Drago
  • Marcello ChinaliEmail author
Original Paper

Abstract

Right ventricular (RV) evaluation represents one of the major clinical tasks in the follow-up of repaired tetralogy of Fallot patients (rToF) with pulmonary valve regurgitation, as both severe RV dilatation and dysfunction are key factors in defining the need of pulmonary valve replacement. The aim of our study was to report the diagnostic accuracy of echocardiography in the identification of rToF patients with severely dilated and/or depressed RV as compared to cardiac magnetic resonance (CMR). Among our patients with rToF, a subgroup of 95 (17.6 ± 6.8 years; 60% male), who underwent right ventricular qualitative and quantitative evaluation with CMR following echocardiographic suspicion of severe dilation/dysfunction, were included in the analysis. When comparing echocardiographic RV functional parameters to CMR findings, we found no association between CMR-ejection fraction (EF) and either tricuspid annulus plane systolic excursion (TAPSe) nor tissue Doppler systolic tricuspid excursion velocity (all p = ns). In contrast RVFAC was strongly associated with CMR-EF (r = 0.44; p < 0.01) as well as to longitudinal components of RV mechanics including tissue Doppler s′ (r = 0.40; p < 0.01) and TAPSE (r = 0.36; p < 0.01). When comparing echocardiographic and CMR structural parameters of the RV, we found that CMR RV volume was strongly related to echocardiographic measurements of RV end diastolic area (from the 4 chamber apical view) and with proximal parasternal short axis right ventricle outflow-dimension. Accordingly a regression model was derived from multiple regression analysis, which allows a more accurate estimate of CMR RV volume from echocardiography (r2 = 0.59, p < 0.001). Our study demonstrates a significant, although imperfect, correlation between echocardiographic and CMR RV functional and geometrical parameters. Combining echocardiographic measures of RV inflow and RV outflow, we deliver a simple formula to estimate CMR-RV volume, improving the echocardiographic accuracy in RV volume quantification.

Keywords

Echocardiogram Right ventricular Accuracy CMR Congenital 

Notes

Acknowledgements

The present work was presented in abstract form at the European Meeting of Echocardiography and Cardiovascular Imaging 2015 (EuroECHO 2015, Seville, Spain).

Funding

Research received no grant from any funding agency in the public, commercial or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Supplementary material

Supplementary material 1 (AVI 2773 KB)

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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Carolina D’Anna
    • 1
  • Armando Caputi
    • 1
  • Benedetta Natali
    • 1
  • Benedetta Leonardi
    • 2
  • Aurelio Secinaro
    • 3
  • Gabriele Rinelli
    • 1
  • Alessia Del Pasqua
    • 1
  • Claudia Esposito
    • 1
  • Adriano Carotti
    • 4
  • Fabrizio Drago
    • 2
  • Marcello Chinali
    • 1
    Email author
  1. 1.Echocardiography Unit, Division of Pediatric Cardiology and Arrhythmology, Department of Pediatric Cardiology and Cardiac SurgeryBambino Gesù Children Hospital-IRCCSRomeItaly
  2. 2.Division of Pediatric Cardiology and Arrhythmology, Department of Pediatric Cardiology and Cardiac SurgeryBambino Gesù Children Hospital-IRCCSRomeItaly
  3. 3.Department of Radiology and BioimagingBambino Gesù Children Hospital-IRCCSRomeItaly
  4. 4.Division of Pediatric Cardiac Surgery, Department of Pediatric Cardiology and Cardiac SurgeryBambino Gesù Children Hospital-IRCCSRomeItaly

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