Correlation of right ventricular ejection fraction and tricuspid annular plane systolic excursion in tetralogy of Fallot by magnetic resonance imaging |
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Authors: | Peter Morcos III" target="_blank">G Wesley VickIII David J Sahn Michael Jerosch-Herold Alan Shurman Florence H Sheehan |
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Institution: | (1) The Cardiovascular Research and Training Center, University of Washington, Box 356422, Seattle, WA 98195-6422, USA;(2) Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA;(3) Pediatric Cardiology, Oregon Health & Science University, Portland, OR, USA;(4) Cardiovascular Imaging Section, Brigham & Women’s Hospital, Boston, MA, USA;(5) North Cascade Cardiology, Bellingham, WA, USA |
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Abstract: | The correlation between right ventricular ejection fraction (RVEF) and tricuspid annular plane systolic excursion (TAPSE)
by two-dimensional (2-D) echo has been repeatedly validated, but not by magnetic resonance imaging (MRI) nor in patients with
congenital heart disease. We tested whether TAPSE measurements by MRI correlate with RVEF in surgically repaired tetralogy
of Fallot (TOF) patients. TAPSE was measured from systolic displacement of the RV-freewall/tricuspid annular plane junction
in the apical 4-chamber view in 7 normal subjects and 14 TOF patients. The RV was reconstructed in 3-D from manually traced
borders on MR images to compute true EF. Because we previously observed discrepancy between TAPSE and RVEF in the presence
of regional dysfunction, we also analyzed RV wall motion in terms of regional stroke volume at 20 short axis slices from apex
to tricuspid annulus. RVEF was 52 ± 3% in normal subjects and 41 ± 9% in TOF (P < 0.01). TAPSE correlated weakly (r = 0.50, P < 0.05) with RVEF. TOF patients exhibited increased regional stroke volume from apical portions of the RV and decreased regional
stroke volume at the base compared to normal (P < 0.05 at 15 of 20 slices). Regional stroke volume in apical slices correlated inversely with RVEF such that patients with
higher apical stroke volume had lower RVEF (P < 0.05). TAPSE is not a reliable measure of RVEF in TOF by MRI. TAPSE may be of limited use in conditions that exhibit abnormal
regional contraction. |
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Keywords: | Right ventricular function Tricuspid annular plane systolic excursion Congenital heart disease |
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