Rongzhen Ouyang1, Shuang Leng2, Aimin Sun1, Qian Wang1, Liwei Hu1, Xiaodan Zhao2, Qin Yan3, Ru-San Tan2,4, Liang Zhong5,6, Yumin Zhong7. 1. Diagnostic Imaging Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Rd, Shanghai, 200127, China. 2. National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore. 3. Department of Cardiovascular Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Rd, Shanghai, 200127, China. 4. Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore. 5. National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore. zhong.liang@nhcs.com.sg. 6. Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore. zhong.liang@nhcs.com.sg. 7. Diagnostic Imaging Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Rd, Shanghai, 200127, China. zyumin2002@163.com.
Abstract
OBJECTIVES: A fast cardiovascular magnetic resonance (CMR) feature tracking was applied to assess ventricular systolic and diastolic function. This study sought to detect right ventricular (RV) systolic and diastolic abnormalities in asymptomatic pediatric repaired tetralogy of Fallot (rTOF) patients with preserved RV ejection fraction (EF). METHODS: One hundred asymptomatic pediatric rTOF patients with preserved RVEF ≥ 45% and 52 control subjects underwent cine CMR examinations. Tricuspid annular plane systolic excursion (TAPSE); peak tricuspid annular systolic (Sm), early diastolic (Em), and late diastolic (Am) velocities; and biventricular global radial (GRS), circumferential (GCS), and longitudinal strains (GLS) were analyzed using CMR feature tracking. RESULTS: TAPSE, Sm, Em, Am, and RV GLS were significantly lower in rTOF patients compared with controls (all p < 0.01). The lower limits (mean-2·standard deviations) of TAPSE, Sm, Em, and Am among controls were 10.9 mm, 6.3 cm/s, 8.9 cm/s, and 2.4 cm/s, respectively, and 78%, 75%, 75%, and 19% of rTOF patients had corresponding measurements below these thresholds. Among rTOF patients, RV GLS was significantly lower in females than in males (p < 0.05). CONCLUSIONS: Despite preserved RVEF, there was a high prevalence of RV systolic and diastolic dysfunction among pediatric rTOF patients, which was detected using fast CMR feature tracking. KEY POINTS: • There was high prevalence of systolic and diastolic dysfunction in asymptomatic pediatric repaired tetralogy of Fallot (rTOF) patients despite preserved right ventricular (RV) ejection fraction (EF). • Significant correlations were observed between right ventricular (RV) measurements (strains, tricuspid annular plane systolic excursion (TAPSE), peak tricuspid annular early diastolic velocity (Em), peak tricuspid annular late diastolic velocity (Am)), and left ventricular (LV) strain measurements, which indicates ventricular-ventricular interactions at systolic and diastolic function level. • Right ventricular (RV) global longitudinal strain (GLS) was lower in female repaired tetralogy of Fallot (rTOF) patients than in males, suggesting females with rTOF may be at a higher risk of developing RV systolic dysfunction than males.
OBJECTIVES: A fast cardiovascular magnetic resonance (CMR) feature tracking was applied to assess ventricular systolic and diastolic function. This study sought to detect right ventricular (RV) systolic and diastolic abnormalities in asymptomatic pediatric repaired tetralogy of Fallot (rTOF) patients with preserved RV ejection fraction (EF). METHODS: One hundred asymptomatic pediatric rTOF patients with preserved RVEF ≥ 45% and 52 control subjects underwent cine CMR examinations. Tricuspid annular plane systolic excursion (TAPSE); peak tricuspid annular systolic (Sm), early diastolic (Em), and late diastolic (Am) velocities; and biventricular global radial (GRS), circumferential (GCS), and longitudinal strains (GLS) were analyzed using CMR feature tracking. RESULTS: TAPSE, Sm, Em, Am, and RV GLS were significantly lower in rTOF patients compared with controls (all p < 0.01). The lower limits (mean-2·standard deviations) of TAPSE, Sm, Em, and Am among controls were 10.9 mm, 6.3 cm/s, 8.9 cm/s, and 2.4 cm/s, respectively, and 78%, 75%, 75%, and 19% of rTOF patients had corresponding measurements below these thresholds. Among rTOF patients, RV GLS was significantly lower in females than in males (p < 0.05). CONCLUSIONS: Despite preserved RVEF, there was a high prevalence of RV systolic and diastolic dysfunction among pediatric rTOF patients, which was detected using fast CMR feature tracking. KEY POINTS: • There was high prevalence of systolic and diastolic dysfunction in asymptomatic pediatric repaired tetralogy of Fallot (rTOF) patients despite preserved right ventricular (RV) ejection fraction (EF). • Significant correlations were observed between right ventricular (RV) measurements (strains, tricuspid annular plane systolic excursion (TAPSE), peak tricuspid annular early diastolic velocity (Em), peak tricuspid annular late diastolic velocity (Am)), and left ventricular (LV) strain measurements, which indicates ventricular-ventricular interactions at systolic and diastolic function level. • Right ventricular (RV) global longitudinal strain (GLS) was lower in female repaired tetralogy of Fallot (rTOF) patients than in males, suggesting females with rTOF may be at a higher risk of developing RV systolic dysfunction than males.
Authors: Rachel M Wald; Anne Marie Valente; Kimberlee Gauvreau; Sonya V Babu-Narayan; Gabriele Egidy Assenza; Jenna Schreier; Michael A Gatzoulis; Philip J Kilner; Zeliha Koyak; Barbara Mulder; Andrew J Powell; Tal Geva Journal: Heart Date: 2015-08-14 Impact factor: 5.994
Authors: Clayton A Smith; Courtney McCracken; Amanda S Thomas; Logan G Spector; James D St Louis; Matthew E Oster; James H Moller; Lazaros Kochilas Journal: JAMA Cardiol Date: 2019-01-01 Impact factor: 14.676
Authors: Catriona J Bhagra; Edward J Hickey; Alexander Van De Bruaene; S Lucy Roche; Eric M Horlick; Rachel M Wald Journal: Can J Cardiol Date: 2017-06-27 Impact factor: 5.223
Authors: Juan Villafañe; Jeffrey A Feinstein; Kathy J Jenkins; Robert N Vincent; Edward P Walsh; Anne M Dubin; Tal Geva; Jeffrey A Towbin; Meryl S Cohen; Charles Fraser; Joseph Dearani; David Rosenthal; Beth Kaufman; Thomas P Graham Journal: J Am Coll Cardiol Date: 2013-09-27 Impact factor: 24.094
Authors: M A Gatzoulis; S Balaji; S A Webber; S C Siu; J S Hokanson; C Poile; M Rosenthal; M Nakazawa; J H Moller; P C Gillette; G D Webb; A N Redington Journal: Lancet Date: 2000-09-16 Impact factor: 79.321
Authors: M A Gatzoulis; J T Elliott; V Guru; S C Siu; M A Warsi; G D Webb; W G Williams; P Liu; P R McLaughlin Journal: Am J Cardiol Date: 2000-12-15 Impact factor: 2.778
Authors: Anne Marie Valente; Kimberlee Gauvreau; Gabriele Egidy Assenza; Sonya V Babu-Narayan; Sarah P Evans; Michael Gatzoulis; Maarten Groenink; Ryo Inuzuka; Philip J Kilner; Zeliha Koyak; Michael J Landzberg; Barbara Mulder; Andrew J Powell; Rachel Wald; Tal Geva Journal: Pediatr Cardiol Date: 2012-06-05 Impact factor: 1.655
Authors: Xiaodan Zhao; Liwei Hu; Shuang Leng; Ru-San Tan; Ping Chai; Jennifer Ann Bryant; Lynette L S Teo; Marielle V Fortier; Tee Joo Yeo; Rong Zhen Ouyang; John C Allen; Marina Hughes; Pankaj Garg; Shuo Zhang; Rob J van der Geest; James W Yip; Teng Hong Tan; Ju Le Tan; Yumin Zhong; Liang Zhong Journal: J Cardiovasc Magn Reson Date: 2022-01-03 Impact factor: 5.364
Authors: Shuang Leng; Jiajun Guo; Ru-San Tan; Ping Chai; Lynette Teo; Marielle V Fortier; Chao Gong; Xiaodan Zhao; Ching Ching Ong; John C Allen; Wen Ruan; Angela S Koh; Teng Hong Tan; James W Yip; Ju Le Tan; Yucheng Chen; Liang Zhong Journal: Front Cardiovasc Med Date: 2021-06-04