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Multivariable assessment of the right ventricle by echocardiography in patients with repaired tetralogy of Fallot undergoing pulmonary valve replacement: a comparative study with magnetic resonance imaging.
Arch Cardiovasc Dis. 2015 Jan; 108(1):5-15.AC

Abstract

BACKGROUND

Evaluation of the right ventricle (RV) using transthoracic echocardiography is challenging in patients with repaired tetralogy of Fallot (rTOF).

AIMS

To evaluate the accuracy of conventional echocardiographic variables and real-time three-dimensional echocardiography (RT3DE) in assessing right ventricular (RV) volumes and function compared with magnetic resonance imaging (MRI), in adult patients with rTOF and referred for pulmonary valve replacement (PVR).

METHODS

Complete echocardiography was performed on 26 consecutive patients referred for PVR, before and 1 year after surgery. All variables were compared with MRI.

RESULTS

Correlations between conventional variables and MRI were absent or poor when assessing RV ejection fraction (RVEF), except for fractional area of change (FAC; r=0.70, P<0.01 before PVR; r=0.68, P<0.01 after PVR) and RT3DE (r=0.96, P<0.01 before PVR; r=0.98, P<0.01 after PVR). The RV volume correlation between RT3DE and MRI was excellent before and after surgery for RV end-diastolic volume (r=0.88, P<0.01 and r=0.91, P<0.01, respectively) and RV end-systolic volume (r=0.92, P<0.01 and r=0.95, P<0.01, respectively). The accuracy of these indices, as a diagnostic test for impaired RV (<45%), was good: Youden's indexes varied from 0.47 to 0.89; areas under the receiver operating characteristic curve before and after PVR were 0.86 and 0.81 for FAC and 0.98 and 0.97 for RT3DE, respectively.

CONCLUSION

Commonly used echocardiography variables, such as tricuspid annular plane systolic excursion and tricuspid annular peak systolic velocity, did not sensitively evaluate global RVEF. A global approach, that includes the whole RV and integration of its different components, was more reliable in patients with rTOF.

Authors+Show Affiliations

Division of Congenital Heart Disease, Bordeaux Hospital University Center, avenue de Magellan, 33604 Bordeaux, France. Electronic address: bernardselly@hotmail.com.Division of Congenital Heart Disease, Bordeaux Hospital University Center, avenue de Magellan, 33604 Bordeaux, France.Division of Congenital Heart Disease, Bordeaux Hospital University Center, avenue de Magellan, 33604 Bordeaux, France.Division of Congenital Heart Disease, Bordeaux Hospital University Center, avenue de Magellan, 33604 Bordeaux, France.Great Ormond Street Hospital for Children, London, United Kingdom.Division of Congenital Heart Disease, Bordeaux Hospital University Center, avenue de Magellan, 33604 Bordeaux, France.Division of Pediatrics, Reunion Hospital University Center, Saint-Pierre, Reunion.Division of Congenital Heart Disease, Bordeaux Hospital University Center, avenue de Magellan, 33604 Bordeaux, France.

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

25453716

Citation

Selly, Jean-Bernard, et al. "Multivariable Assessment of the Right Ventricle By Echocardiography in Patients With Repaired Tetralogy of Fallot Undergoing Pulmonary Valve Replacement: a Comparative Study With Magnetic Resonance Imaging." Archives of Cardiovascular Diseases, vol. 108, no. 1, 2015, pp. 5-15.
Selly JB, Iriart X, Roubertie F, et al. Multivariable assessment of the right ventricle by echocardiography in patients with repaired tetralogy of Fallot undergoing pulmonary valve replacement: a comparative study with magnetic resonance imaging. Arch Cardiovasc Dis. 2015;108(1):5-15.
Selly, J. B., Iriart, X., Roubertie, F., Mauriat, P., Marek, J., Guilhon, E., Jamal-Bey, K., & Thambo, J. B. (2015). Multivariable assessment of the right ventricle by echocardiography in patients with repaired tetralogy of Fallot undergoing pulmonary valve replacement: a comparative study with magnetic resonance imaging. Archives of Cardiovascular Diseases, 108(1), 5-15. https://doi.org/10.1016/j.acvd.2014.07.054
Selly JB, et al. Multivariable Assessment of the Right Ventricle By Echocardiography in Patients With Repaired Tetralogy of Fallot Undergoing Pulmonary Valve Replacement: a Comparative Study With Magnetic Resonance Imaging. Arch Cardiovasc Dis. 2015;108(1):5-15. PubMed PMID: 25453716.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multivariable assessment of the right ventricle by echocardiography in patients with repaired tetralogy of Fallot undergoing pulmonary valve replacement: a comparative study with magnetic resonance imaging. AU - Selly,Jean-Bernard, AU - Iriart,Xavier, AU - Roubertie,François, AU - Mauriat,Philippe, AU - Marek,Jan, AU - Guilhon,Emmanuelle, AU - Jamal-Bey,Karim, AU - Thambo,Jean-Benoît, Y1 - 2014/11/12/ PY - 2013/12/22/received PY - 2014/07/17/revised PY - 2014/07/23/accepted PY - 2014/12/3/entrez PY - 2014/12/3/pubmed PY - 2015/9/17/medline KW - Echocardiography KW - IRM KW - Magnetic resonance imaging KW - Pulmonary valve replacement KW - Remplacement valvulaire pulmonaire KW - Right ventricle KW - Tetralogy of Fallot KW - Tétralogie de Fallot KW - Ventricule droit KW - Échocardiographie SP - 5 EP - 15 JF - Archives of cardiovascular diseases JO - Arch Cardiovasc Dis VL - 108 IS - 1 N2 - BACKGROUND: Evaluation of the right ventricle (RV) using transthoracic echocardiography is challenging in patients with repaired tetralogy of Fallot (rTOF). AIMS: To evaluate the accuracy of conventional echocardiographic variables and real-time three-dimensional echocardiography (RT3DE) in assessing right ventricular (RV) volumes and function compared with magnetic resonance imaging (MRI), in adult patients with rTOF and referred for pulmonary valve replacement (PVR). METHODS: Complete echocardiography was performed on 26 consecutive patients referred for PVR, before and 1 year after surgery. All variables were compared with MRI. RESULTS: Correlations between conventional variables and MRI were absent or poor when assessing RV ejection fraction (RVEF), except for fractional area of change (FAC; r=0.70, P<0.01 before PVR; r=0.68, P<0.01 after PVR) and RT3DE (r=0.96, P<0.01 before PVR; r=0.98, P<0.01 after PVR). The RV volume correlation between RT3DE and MRI was excellent before and after surgery for RV end-diastolic volume (r=0.88, P<0.01 and r=0.91, P<0.01, respectively) and RV end-systolic volume (r=0.92, P<0.01 and r=0.95, P<0.01, respectively). The accuracy of these indices, as a diagnostic test for impaired RV (<45%), was good: Youden's indexes varied from 0.47 to 0.89; areas under the receiver operating characteristic curve before and after PVR were 0.86 and 0.81 for FAC and 0.98 and 0.97 for RT3DE, respectively. CONCLUSION: Commonly used echocardiography variables, such as tricuspid annular plane systolic excursion and tricuspid annular peak systolic velocity, did not sensitively evaluate global RVEF. A global approach, that includes the whole RV and integration of its different components, was more reliable in patients with rTOF. SN - 1875-2128 UR - https://www.unboundmedicine.com/medline/citation/25453716/Multivariable_assessment_of_the_right_ventricle_by_echocardiography_in_patients_with_repaired_tetralogy_of_Fallot_undergoing_pulmonary_valve_replacement:_a_comparative_study_with_magnetic_resonance_imaging_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1875-2136(14)00243-5 DB - PRIME DP - Unbound Medicine ER -