Key result
Echocardiography-derived functional right ventricular fractional area change showed excellent correlation (rho = 0.812) with CMR-derived right ventricular ejection fraction in pediatric patients with Ebstein anomaly.
Why the study?
With a trend toward childhood surgery in Ebstein anomaly, thorough imaging is crucial for patient selection, motivating an assessment of biventricular function by echocardiography and CMR and a comparison of EA severity classifications.
Does the combination of echocardiography and CMR improve the comprehensive evaluation of biventricular function and severity in pediatric patients with Ebstein anomaly?
Cross-Sectional (n=23)
Yes
Does the combination of echocardiography and CMR improve the comprehensive evaluation of biventricular function and severity in pediatric patients with Ebstein anomaly?
In pediatric patients with Ebstein anomaly, echocardiography and CMR provide complementary information, with excellent correlation for right ventricular function but CMR offering superior volumetric assessment.
Biventricular dysfunction is common in pediatric EA; leaves open whether CMR refines surgical selection beyond echocardiography.
With the trend towards childhood surgery in patients with Ebstein anomaly (EA), thorough imaging is crucial for patient selection. This study aimed to assess biventricular function by echocardiography and cardiac magnetic resonance (CMR) and compare EA severity classifications. Twenty-three patients (8-17 years) underwent echocardiography and CMR. Echocardiographic parameters included tricuspid annular plane systolic excursions (TAPSE), fractional area change of the functional right ventricle (fRV-FAC), fRV free wall peak systolic myocardial velocity (fRVs'), and tricuspid regurgitation (TR). End-diastolic and end-systolic volume (EDV resp. ESV), fRV- and LV ejection fraction (EF) and TR were obtained by CMR. EA severity classifications included displacement index, Celermajer index and the total-right/left-volume index. Median fRV-FAC was 38% (IQR 33-42). TAPSE and fRVs' were reduced in 39% and 75% of the patients, respectively. Echocardiographic TR was visually graded as mild, moderate, or severe in nine, six and eight patients, respectively. By CMR, median fRVEF was 49% (IQR 36-58) and TR was graded as mild, moderate, or severe in nine, twelve and two patients, respectively. In 70% of cases, fRV-EDV was higher than LV-EDV. LVEF was decreased in 17 cases (74%). There was excellent correlation between echocardiography-derived fRV-FAC and CMR-derived fRVEF (rho = 0.812, p < 0.001). While echocardiography is a versatile tool in the complex geometry of the Ebstein heart, it has limitations. CMR offers a total overview and has the advantage of reliable volume assessment of both ventricles. Comprehensive evaluation of pediatric patients with EA may therefore require a synergistic implementation of echocardiography and CMR.
No takes yet. Share an insight, caveat, or question.
Geerdink et al. (2022) conducted a cross-sectional in Ebstein anomaly (n=23). Echocardiography and Cardiac Magnetic Resonance Imaging was evaluated on Correlation between echocardiography-derived fRV-FAC and CMR-derived fRVEF (rho = 0.812, p=<0.001). Echocardiography-derived functional right ventricular fractional area change showed excellent correlation (rho = 0.812) with CMR-derived right ventricular ejection fraction in pediatric patients with Ebstein anomaly.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: