Abstract

Outcome in patients with congenital heart diseases and pulmonary arterial hypertension (PAH) is closely related to right ventricular (RV) function. Two-dimensional echocardiographic parameters, such as strain imaging or RV end-systolic remodeling index (RVESRI) have emerged to quantify RV function.We prospectively studied 30 patients aged 48 ± 12 years with pretricuspid shunt and PAH and investigated the accuracy of multiple echocardiographic parameters of RV function (tricuspid annular plane systolic excursion, tricuspid annular peak systolic velocity, RV systolic-to-diastolic duration ratio, right atrial area, RV fractional area change, RV global longitudinal strain and RVESRI) to RV ejection fraction measured by cardiac magnetic resonance.RV ejection fraction < 45% was observed in 13 patients (43.3%). RV global longitudinal strain (? [Spearman's correlation coefficient] = -0.75; P = .001; R² = 0.58; P = .001), right atrium area (? = -0.74; P < .0001; R² = 0.56; P < .0001), RVESRI (? = -0.64; P < .0001; R² = 0.47; P < .0001), systolic-to-diastolic duration ratio (? = -0.62; P = .0004; R² = 0.47; P < .0001) and RV fractional area change (? = 0.48; P = .01; R² = 0.37; P < .0001) were correlated with RV ejection fraction. RV global longitudinal strain, RVESRI and right atrium area predicted RV ejection fraction < 45% with the greatest area under curve (0.88; 95%CI, 0.71-1.00; 0.88; 95%CI, 0.76-1.00, and 0.89; 95%CI, 0.77-1.00, respectively). RV global longitudinal strain > -16%, RVESRI = 1.7 and right atrial area = 22cm² predicted RV ejection fraction < 45% with a sensitivity and specificity of 87.5% and 85.7%; 76.9% and 88.3%; 92.3% and 82.4%, respectively.RVESRI, right atrial area and RV global longitudinal strain are strong markers of RV dysfunction in patients with pretricuspid shunt and PAH.

View details for DOI 10.1016/j.rec.2022.07.010

View details for PubMedID 35940550