Regional Analysis of Longitudinal Systolic Function of the Right Ventricle After Corrective Surgery of Tetralogy of Fall
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ORIGINAL ARTICLE
Regional Analysis of Longitudinal Systolic Function of the Right Ventricle After Corrective Surgery of Tetralogy of Fallot Using Myocardial Isovolumetric Acceleration Index Mohamed Y. Abd El Rahman • Wei Hui • Rita Schuck • Axel Rentzsch • Felix Berger M. Gutberlet • Hashim Abdul-Khaliq
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Received: 29 January 2013 / Accepted: 29 May 2013 Ó Springer Science+Business Media New York 2013
Abstract To assess regional longitudinal systolic function of the right ventricle in patients with repaired tetralogy of Fallot (TOF) by tissue Doppler imaging-derived isovolumetric acceleration (IVA) index and determine the effect of right-ventricular (RV) enlargement on regional systolic function. In 30 consecutive TOF patients and 30 age-matched controls, myocardial velocity of the RV ventricular free wall in the basal and middle regions were examined in the apical four-chamber view. Peak myocardial velocity during IVA was recorded on the free RV wall. IVA index was calculated as the difference between baseline and peak velocity divided by their time interval. In 23 of the studied TOF patients, magnetic resonance
imaging was performed on the same day to determine global RV volume and ejection fraction. IVA index of the RV lateral free wall was significantly lower in the basal (8.31 ± 6.00 vs. 19.00 ± 10.85 m/s2, p = 0.0001) and middle segments (6.56 ± 5.22 vs. 16.17 ± 7.44 m/s2, p = 0.0001) in patients than in controls. Among TOF patients, a negative correlation was found between IVA index in the middle segment and RV end-diastolic volume/ body surface area (r = -0.549, p \ 0.01). Similar to other longitudinal RV wall parameters, the IVA index showed a decreased value in the RV free wall, which is related to the impaired regional and global longitudinal RV systolic dysfunction. RV enlargement adversely affects regional longitudinal systolic function.
M. Y. Abd El Rahman W. Hui R. Schuck F. Berger H. Abdul-Khaliq Department of Congenital Heart Disease, Deutsches Herzzentrum, Berlin, Germany
Keywords Tetralogy of Fallot Right-ventricular function Tissue Doppler imaging Isovolumetric acceleration index Magnetic resonance imaging
M. Y. Abd El Rahman A. Rentzsch H. Abdul-Khaliq (&) Department of Pediatric Cardiology, Saarland University Hospital, Kirrberger Straße, 66421 Homburg/Saar, Germany e-mail: [email protected]
Introduction
M. Y. Abd El Rahman Department of Pediatrics and Pediatric Cardiology, Cairo University, Cairo, Egypt W. Hui Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada M. Gutberlet Department of Radiology and Nuclear Medicine, Charite Campus Virchow Klinikum, Berlin, Germany M. Gutberlet Department of Diagnostic and Interventional Radiology, University of Leipzig-Heart Center, Leipzig, Germany
Tetralogy of Fallot (TOF) is the most common congenital cyanotic heart disease occurring beyond infancy and accounts for approximately 10 % of all congenital cardiac defects [2]. Since the first successful surgical correc
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