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Assessment of regional and global right ventricular systolic function in children with repaired tetralogy of Fallot

Published online by Cambridge University Press:  22 February 2021

Elizabeth Caris Open the ORCID record for Elizabeth Caris [Opens in a new window]  and
Stacey Drant
Elizabeth Caris*
Affiliation:
Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA, USA
Stacey Drant
Affiliation:
Pediatric Cardiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
*
Author for correspondence: Elizabeth Caris, 4800 Sand Point Way NE, M/S RC.2.820. PO Box 5371, Seattle, WA 98105, USA. Fax: 206-987-3839. Email: [email protected]
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Abstract

Background:

Echo assessment of right ventricular function is difficult due to its complex geometry and regional differences in wall motion. In patients with repaired tetralogy of Fallot, cardiac MRI is the gold standard for assessment of right ventricular function. There is scant data regarding the correlation of echo measures of right ventricular function with cardiac MRI right ventricular function in the paediatric population.

Methods:

Echocardiographic measures of regional and global right ventricular function were reviewed in 56 patients with repaired tetralogy of Fallot and 27 patients with structurally normal hearts. These measures were compared to global right ventricular ejection fraction by cardiac MRI.

Results:

Despite having the same right ventricular ejection fraction by cardiac MRI as normal controls, patients with repaired tetralogy of Fallot had significantly worse global and regional echocardiographic measures of right ventricular function. Right ventricular fractional area change and fractional shortening of the right ventricular outflow tract correlated best with global right ventricular function by MRI. Incorporation of these measures into a regression model allowed accurate prediction of global right ventricular function by cardiac MRI.

Conclusion:

Children with repaired tetralogy of Fallot have abnormal regional and global right ventricular function compared to patients with normal hearts. Despite the presence of patch material, the right ventricular outflow tract significantly contributes to global right ventricular function by cardiac MRI. When incorporated into a model that includes regional and global echocardiographic measures of right ventricular function, right ventricular outflow tract fractional shortening helps predict global right ventricular function by MRI.

Keywords

Tetralogy of Fallotechocardiographycardiac MRI
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 10 , October 2021 , pp. 1571 - 1575
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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