Key result
In patients with repaired Tetralogy of Fallot, RVGLS was significantly lower than in controls (-17.4% vs -25.6%) and an RVGLS cutoff of -17.4% identified RVEF <45% with an AUC of 0.743 (P<0.05).
Why the study?
Right ventricular function is an important prognostic factor in repaired Tetralogy of Fallot, motivating assessment by conventional echocardiography and two-dimensional speckle tracking echocardiography.
Does 2D speckle tracking echocardiography accurately assess right ventricular systolic function compared to cardiac magnetic resonance in patients with repaired Tetralogy of Fallot?
Case-Control (n=54)
Does 2D speckle tracking echocardiography accurately assess right ventricular systolic function compared to cardiac magnetic resonance in patients with repaired Tetralogy of Fallot?
Right ventricular global longitudinal strain by speckle tracking echocardiography is a feasible and effective tool that correlates well with cardiac MRI for evaluating right ventricular systolic function in patients with repaired Tetralogy of Fallot.
Answers are grounded in this paper and cite their sources.
RV GLS by 2D-STE correlates with CMRI RVEF in repaired TOF; hypothesis-generating and requires prospective validation before routine adoption.
BACKGROUND: Right ventricular (RV) function is one of the important prognostic factors in patients with repaired Tetralogy of Fallot (TOF). We aimed to assess RV function by conventional echocardiography and two-dimensional speckle tracking echocardiography (2D-STE) in patients with repaired TOF. METHODS: Twenty-seven (male 17) adolescents and young adult patients (mean age 22.7 ± 6.7 years) operated on for TOF and age- and gender-matched healthy controls were included. RV systolic function in both groups were evaluated by fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), RV myocardial performance index (RVMPI) and tricuspid annular peak systolic velocity by pulsed tissue Doppler (tricuspid S'), and also RV global longitudinal strain (RV GLS) obtained from STE. These results were compared with RV ejection fraction (RVEF) measured by cardiac magnetic resonance imaging (CMRI) performed within 3 months in patient group. RESULTS: Systolic RVGLS values were significantly lower in patients compared to controls (-17.4 ± 3.1% vs -25.6 ± 3%). Among the echocardiographic parameters, RVGLS had the best correlation with RV EF derived from CMRI (r: -.6). By receiver operating characteristics analysis (ROC), an RV GLS cutoff value of -17.4% had 75% sensitivity and 68.4% specificity in identifying RVEF <45% with an area under curve 0.743 (P < .05). The intra- and inter-observer agreement for RV GLS was excellent. CONCLUSION: RVGLS is an easy, effective, feasible, and reproducible tool in the evaluation of RV systolic function. So, RVGLS measurement by STE may be one of the routine echocardiographic parameters in the evaluation of RV systolic function in patients with repaired TOF.
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Kavurt et al. (2019) conducted a case-control in Repaired Tetralogy of Fallot (n=54). Repaired Tetralogy of Fallot vs. Healthy controls was evaluated on Systolic RV global longitudinal strain (RVGLS). In patients with repaired Tetralogy of Fallot, RVGLS was significantly lower than in controls (-17.4% vs -25.6%) and an RVGLS cutoff of -17.4% identified RVEF <45% with an AUC of 0.743 (P<0.05).
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