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Evaluation of tricuspid annular plane systolic excursion measured with cardiac MRI in children with tetralogy of Fallot

  • Jonathan H. Soslow (a1), Emem Usoro (a2), Li Wang (a3) and David A. Parra (a1)

Abstract

Background

Aneurysmal dilation of the right ventricular outflow tract complicates assessment of right ventricular function in patients with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is commonly used to estimate ejection fraction. We hypothesised that tricuspid annular plane systolic excursion measured by cardiac MRI approximates global and segmental right ventricular function, specifically right ventricular sinus ejection fraction, in children with repaired tetralogy of Fallot.

Methods

Tricuspid annular plane systolic excursion was measured retrospectively on cardiac MRIs in 54 patients with repaired tetralogy of Fallot. Values were compared with right ventricular global, sinus, and infundibular ejection fractions. Tricuspid annular plane systolic excursion was indexed to body surface area, converted into a fractional value, and converted into published paediatric Z-scores.

Results

Tricuspid annular plane systolic excursion measurements had good agreement between observers. Right ventricular ejection fraction did not correlate with the absolute or indexed tricuspid annular plane systolic excursion and correlated weakly with fractional tricuspid annular plane systolic excursion (r=0.41 and p=0.002). Segmental right ventricular function did not appreciably improve correlation with any of the tricuspid annular plane systolic excursion measures. Paediatric Z-scores were unable to differentiate patients with normal and abnormal right ventricular function.

Conclusions

Tricuspid annular plane systolic excursion measured by cardiac MRI correlates poorly with global and segmental right ventricular ejection fraction in children with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is an unreliable approximation of right ventricular function in this patient population.

Copyright

Corresponding author

Correspondence to: J. H. Soslow, MD, MSCI, Vanderbilt University Medical Center, 2200 Children’s Way, Suite 5230, DOT, Nashville, TN 37232, United States of America. Tel: +615 322 7447; Fax: +615 322 2210; E-mail: jonathan.h.soslow@vanderbilt.edu

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Evaluation of tricuspid annular plane systolic excursion measured with cardiac MRI in children with tetralogy of Fallot

  • Jonathan H. Soslow (a1), Emem Usoro (a2), Li Wang (a3) and David A. Parra (a1)

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