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Doppler-derived strain and strain rate imaging assessment of right ventricular systolic function in adults late after tetralogy of Fallot repair: an observational study [Anatol J Cardiol]
Anatol J Cardiol. 2013; 13(6): 536-542 | DOI: 10.5152/akd.2013.174  

Doppler-derived strain and strain rate imaging assessment of right ventricular systolic function in adults late after tetralogy of Fallot repair: an observational study

Anita Sadeghpour1, Majid Kyavar2, Shabnam Madadi2, Leili Ebrahimi1, Zahra Khajali3, Zahra Alizadeh Sani2
1Echocardiography Laboratory, Cardiac Imaging and Echocardiography Research Center, Tehran-Iran
2CMR Department, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Echocardiography Research Center, Tehran-Iran
3Echocardiography Laboratory, Department of Cardiovascular Medicine, Echocardiography Research Center, Tehran-Iran

Objective: Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. Today, we are faced with an increasing number of patients with residual pulmonary regurgitation (PR) late after TOF repair. The right ventricular (RV) volumes and function are among the most important factors influencing clinical decision-making. Cardiac magnetic resonance (CMR) is the gold standard method for the quantitative assessment of the RV function; it is, however, expensive for routine clinical follow-up and sometimes is contraindicated. We sought to evaluate the RV systolic function via CMR and compare it with Doppler-derived strain(S) and strain rate (SR) imaging in patients with repaired TOF. Methods: In an observational cross-sectional study, 70 patients (22 women, mean age=224.9 years) late after TOF repair with severe PR were evaluated. Peak systolic strain and SR in the basal, mid, and apical segments of RV free wall (RVFW) were measured and compared with the RV function measured in the short-axis cine MR. Associations between RVEF and S/SR, investigated by ordinal logistic regression models. Results: Significant association was observed between RV function and mean S of all the three segments of the RVFW segments [OR (CI95%): 1.17 (1.05-1.31)]. Association between RV function and mean SR of all the three segments of the RVFW segments was borderline significant [OR (CI95%): 1.7 (0.97-2.93)]. Conclusion: There was a significant correlation between the Doppler-derived mean strain of RVFW and the RV function measured by CMR in adults late after TOF repair. These quantitative methods improved the assessment of the RV function and served as an additional method to follow up patients with contraindications to CMR.

Keywords: Tetralogy of Fallot, right ventricle, cardiac magnetic resonance, strain, regression analysis, diagnostic value, sensitivity, specificity


Anita Sadeghpour, Majid Kyavar, Shabnam Madadi, Leili Ebrahimi, Zahra Khajali, Zahra Alizadeh Sani. Doppler-derived strain and strain rate imaging assessment of right ventricular systolic function in adults late after tetralogy of Fallot repair: an observational study. Anatol J Cardiol. 2013; 13(6): 536-542


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