Quantitative assessment of the entire right ventricle from one acoustic window: An attractive approach in patients with congenital heart disease in daily practice

Quantitative assessment of the entire right ventricle from one acoustic window: An attractive approach in patients with congenital heart disease in daily practice

Right ventricular (RV) function is recognized as an important prognostic factor in adult congenital heart disease (ACHD). The accuracy of established parameters including tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC) and tissue Doppler imaging (TDI S′) is limi...

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Bibliographic Details
Published in:International journal of cardiology Vol. 331; pp. 75 - 81
Main Authors: Van Berendoncks, An M.L., Bowen, Daniel J., McGhie, Jackie, Cuypers, Judith, Kauling, Robert M., Roos-Hesselink, Jolien, Van den Bosch, Annemien E.
Format: Journal Article
Language:English
Published: Netherlands Elsevier B.V 15-05-2021
Subjects:
Adult congenital heart disease
Echocardiography
Electronic plane rotation
Right ventricular function
RV strain
ACHD
NYHA
Echocardiography
RV
TTE
Adult congenital heart disease
LS
Electronic plane rotation
TAPSE
GLS
RVFAC
CV
Right ventricular function
TDI
RV strain
TR
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Summary:Right ventricular (RV) function is recognized as an important prognostic factor in adult congenital heart disease (ACHD). The accuracy of established parameters including tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC) and tissue Doppler imaging (TDI S′) is limited as only a small RV region is reflected. We previously introduced a novel four-view approach with different RV walls visualized from one apical view using electronic plane rotation, also known as iRotate. To evaluate the entire RV function using electronic plane rotation echocardiography within the spectrum of ACHD compared with healthy subjects. One hundred and forty-two ACHD patients were recruited from the outpatient clinic and 89 healthy subjects. All subjects underwent a transthoracic echocardiogram with evaluation of TAPSE, TDI S′ and peak systolic longitudinal RV strain (RV-LS) from all RV walls using the four-view electronic plane rotation model. With exception of TDI S′ in inferior coronal view, all parameters were lower in ACHD vs healthy subjects (p < 0.001). Within the ACHD patients, RV strain was lower in anterior (−15.9 ± 4.9) and inferior coronal view (−15.1 ± 4.5) versus lateral (−17.6 ± 5.0) and inferior wall (−17.2 ± 4.7) (p < 0.05). RV-LS values of systemic RV were lower (p < 0.05), but no difference was observed between subpulmonic RV loading conditions. The four-view electronic plane rotation model represents a reproducible, easily applicable and complete RV assessment in daily practice. RV function is significantly decreased in the ACHD group using both regional and global assessment parameters. Complete RV strain analysis reveals regional differences. •Complete RV strain analysis reveals regional differences that needs further exploration in larger ACHD subgroups.•A deterioration of RV systolic function with increasing afterload can also be noticed in the ACHD group with subpulmonic RV physiology.•RV function is significantly decreased in the ACHD group, especially the systemic RV in patients with TGA.•Deterioration of RV systolic function with increasing afterload can be noticed in the ACHD group with subpulmonic RV physiology.•Multiplane imaging is an easy applicable and feasible approach to evaluate the entire right ventricle in ACHD patients.
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ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2021.01.050