Key result
Adults with repaired Tetralogy of Fallot had significantly reduced right ventricular function compared to healthy controls, including a lower four-wall averaged longitudinal strain (-16.8% vs -23.6%).
Why the study?
Detailed right ventricular functional assessment is important for managing repaired Tetralogy of Fallot and timing pulmonary valve re-intervention, prompting evaluation of two-dimensional multi-plane echocardiography.
Is two-dimensional multi-plane echocardiography feasible and effective for assessing regional right ventricular function in adults with repaired Tetralogy of Fallot compared to 3D echocardiography?
Cross-Sectional (n=124)
No
Is two-dimensional multi-plane echocardiography feasible and effective for assessing regional right ventricular function in adults with repaired Tetralogy of Fallot compared to 3D echocardiography?
2D multi-plane echocardiography is a highly feasible tool that provides detailed regional right ventricular functional assessment in adults with repaired Tetralogy of Fallot, outperforming 3D echocardiography in feasibility.
RV dysfunction persists in repaired TOF; supports 2D multi-plane echo feasibility but leaves open clinical adoption.
Background In patients with repaired Tetralogy of Fallot (ToF), detailed assessment of right ventricular (RV) function is important for management and timing of possible pulmonary valve re-intervention. The aim of this study was to evaluate RV function using two-dimensional multi-plane echocardiography (2D MPE), a novel four-wall imaging method obtained from one apical acoustic window utilising electronic plane rotation. Methods and Results In sixty-two ToF patients (aged - 28 [22, 39] years, 65 % male), systolic function of four different RV walls (lateral, anterior, inferior and inferior coronal) were evaluated using MPE. Tricuspid annular plane systolic excursion (TAPSE), tricuspid annular peak systolic velocity (RV-S’) and RV wall longitudinal strain (RV-LS) measurements were compared with those of matched healthy individuals. 2D MPE measurements were highly feasible across the four RV walls (93.5-100% for TAPSE/S’; 66.1-95.1% for RV-LS) and could be performed more reliably than 3D RV ejection fraction (RVEF - 56.5%). All functional values were significantly reduced when compared to the control group (p<0.001). Higher RV-LS values were seen in the lateral (-17.8±4.5%) and inferior (-17.8±4.2%) walls compared to the anterior (-15.9±3.8%) and inferior coronal (-15.1±3.9%) walls. 3D RVEF correlated strongest with RV-LS values from the lateral (r -0.50; p=0.002) and anterior walls (r -0.74; p<0.001) and furthermore the four-wall average (r -0.57; p=0.001). Conclusion 2D MPE evaluation of the RV is highly feasible in ToF patients. This novel method provides new insights into regional RV wall function, enabling a more comprehensive and quantitative approach to RV assessment in daily clinical practice.
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Bowen et al. (2021) conducted a cross-sectional in Repaired Tetralogy of Fallot (n=124). Repaired Tetralogy of Fallot vs. Healthy age and gender matched controls was evaluated on Four-wall averaged right ventricular longitudinal strain (RV-LS) (p=<0.001). Adults with repaired Tetralogy of Fallot had significantly reduced right ventricular function compared to healthy controls, including a lower four-wall averaged longitudinal strain (-16.8% vs -23.6%).
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