Key result
Tricuspid annular plane systolic excursion measured by cardiac MRI correlated weakly with right ventricular ejection fraction (r=0.41, p=0.002), making it an unreliable approximation of RV function.
Why the study?
Does tricuspid annular plane systolic excursion measured by cardiac MRI accurately estimate right ventricular ejection fraction in children with repaired tetralogy of Fallot?
Observational (n=54)
Does tricuspid annular plane systolic excursion measured by cardiac MRI accurately estimate right ventricular ejection fraction in children with repaired tetralogy of Fallot?
Effect estimate: r=0.41
p-value: p=0.002
TAPSE measured by cardiac MRI is an unreliable approximation of right ventricular function in children with repaired tetralogy of Fallot.
TAPSE by cardiac MRI should not approximate RV function in repaired tetralogy of Fallot; leaves open validation of better MRI surrogates in pediatric cohorts.
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.
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Soslow et al. (2015) conducted an observational in Repaired tetralogy of Fallot (n=54). Tricuspid annular plane systolic excursion (TAPSE) measured by cardiac MRI vs. Right ventricular global, sinus, and infundibular ejection fractions was evaluated on Correlation between right ventricular ejection fraction and fractional tricuspid annular plane systolic excursion (r=0.41, p=0.002). Tricuspid annular plane systolic excursion measured by cardiac MRI correlated weakly with right ventricular ejection fraction (r=0.41, p=0.002), making it an unreliable approximation of RV function.
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