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Non-invasive assessment of right ventricular function in the late follow-up of the Senning procedure

Published online by Cambridge University Press:  22 April 2005

Samira S. Morhy ,
Jose L. Andrade ,
Andressa M. Soares ,
Zilma V. Ribeiro ,
Tatiana M. Wilberg ,
Wilson Mathias ,
Jose R. Parga ,
Luis N. P. Bustamante ,
Edmar Atik  and
Jose F. Ramires
Samira S. Morhy
Affiliation:
Imaging Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Jose L. Andrade
Affiliation:
Imaging Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Andressa M. Soares
Affiliation:
Imaging Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Zilma V. Ribeiro
Affiliation:
Imaging Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Tatiana M. Wilberg
Affiliation:
Imaging Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Wilson Mathias
Affiliation:
Imaging Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Jose R. Parga
Affiliation:
Imaging Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Luis N. P. Bustamante
Affiliation:
Clinical Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Edmar Atik
Affiliation:
Clinical Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Jose F. Ramires
Affiliation:
Clinical Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
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Abstract

Deteriorating ventricular function is a major concern after the Senning operation. A Doppler-derived non-geometric measurement, the so-called myocardial performance index, has been described for use in adults and children. We aimed to assess the utility of this index as a method for quantification of right ventricular function in patients in the late follow-up of the Senning procedure, and to correlate the right ventricular ejection fraction and the first derivative of right ventricular pressure as derived using echocardiography with the ejection fraction determined using magnetic resonance imaging.

We studied 44 patients within a mean postoperative period of 15.3 years. We calculated the right ventricular myocardial performance index by pulsed wave Doppler interrogation of tricuspid inflow and aortic outflow, the ejection fraction by Simpson's rule, and the first derivative of right ventricular pressure by continuous wave Doppler from tricuspid regurgitation.

Mean values of right ventricular myocardial performance index, ejection fraction, and the first derivative of right ventricular pressure were 0.50, 39 percent and 1,398 millimetres of mercury per second, respectively. A cut-off value of 0.47 for the right ventricle myocardial performance index was determined, with a sensitivity of 75 percent and a specificity of 62.5 percent. We found no correlation between ejection fraction and the first derivative of right ventricular pressure as estimated by echocardiography and the ejection fraction as shown by magnetic resonance imaging (r2 equal to 0.29 and 0.04 respectively).

We concluded, first, that patients with preserved right ventricular function had values for the right ventricular myocardial performance index lower than 0.47, and second, that ejection fraction and the first derivative of right ventricular pressure as determined echocardiographically did not correlate with values derived using magnetic resonance imaging.

Keywords

Discordant ventriculo-arterial connectionsechocardiographymyocardial performance indextransposition
Type
Original Article
Information
Cardiology in the Young , Volume 15 , Issue 2 , March 2005 , pp. 154 - 159
Copyright
© 2005 Cambridge University Press

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References

Kirjavainen M, Happonen JM, Louhimo I. Late results of Senning operation. J Thorac Cardiovasc Surg 1999; 117: 488–495.Google Scholar
Helbing WA, Bosch HG, Maliepaard C, et al. Comparison of echocardiographic methods with magnetic resonance imaging for assessment of right ventricular function in children. Am J Cardiol 1995; 76: 589–594.Google Scholar
Ishii M, Eto G, Tei C, et al. Quantitation of the global right ventricular function in children with normal heart and congenital heart disease: a right ventricular myocardial performance index. Pediatr Cardiol 2000; 21: 416–421.Google Scholar
Imanishi T, Nakatani S, Yamada S, Nakanishi N, Beppu S, Nagata S. Validation of continuous wave Doppler-determined right ventricular peak positive and negative dP/dt: effect of right atrial pressure on measurement. J Am Coll Cardiol 1994; 23: 1638–1643.Google Scholar
Helbing WA, Rebergen AS, Maliepaard C, et al. Quantification of right ventricular function with magnetic resonance imaging in children with normal hearts and with congenital heart disease. Am Heart J 1995; 130: 828–837.Google Scholar
Eidem BW, O'Leary PW, Tei C, Seward JB. Usefulness of the myocardial performance index for assessing right ventricular function in congenital heart disease. Am J Cardiol 2000; 86: 654–658.Google Scholar
Eidem BW, Tei C, O'Leary PW, Cetta F, Seward JB. Nongeometric quantitative assessment of right and left ventricular function: myocardial performance index in normal children and patients with Ebstein anomaly. J Am Soc Echocardiogr 1998; 11: 849–856.Google Scholar
Tei C. New noninvasive index for combined systolic and diastolic ventricular function. J Cardiol 1995; 26: 135–136.Google Scholar
Tei C, Nishimura RA, Seward JB, Tajik AJ. Noninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements. J Am Soc Echocardiogr 1997; 10: 169–178.Google Scholar
Moller JE, Poulsen SH, Egstrup K. Effect of preload alternations on a new Doppler echocardiographic index of combined systolic and diastolic performance. J Am Soc Echocardiogr 1999; 135: 1065–1072.Google Scholar
LaCorte JC, Cabreriza S, Rabkin DG, et al. Correlation of the Tei Index with invasive measurements of ventricular function in a porcine model. J Am Soc Echocardiogr 2003; 16: 442–447.Google Scholar
Davlouros PA, Kilner PJ, Hornung TS, et al. Right ventricular function in adults with repaired tetralogy of Fallot assessed with cardiovascular magnetic resonance imaging: detrimental role of right ventricular outflow aneurysms or akinesia and adverse right-to-left ventricular interaction. J Am Coll Cardiol 2002; 40: 2044–2052.Google Scholar
Poulsen SH, Nielsen JC, Andersen HR. The influence of heart rate on the Doppler-derived myocardial performance index. J Am Soc Echocardiogr 2000; 13: 379–384.Google Scholar
Hurwitz RA, Caldwell RL, Girod DA, Brown J. Right ventricular systolic function in adolescents and young adults after Mustard operation for transposition of the great arteries. Am J Cardiol 1996; 77: 294–297.Google Scholar
Lissin WL, Wei L, Murphy DJ, et al. Comparison of transthoracic echocardiography versus cardiovascular magnetic resonance imaging for the assessment of ventricular function in adults after atrial switch procedures for complete transposition of the great arteries. Am J Cardiol 2004; 93: 654–657.Google Scholar
Vogel M, Derrick G, White PA, et al. Systemic ventricular function in patients with transposition of great arteries after atrial repair: a tissue Doppler and conductance catheter study. J Am Coll Cardiol 2004; 43: 100–106.Google Scholar