Cardiac MRI assessment of right ventricular function: impact of right bundle branch block on the evaluation of cardiac performance parameters
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Right ventricular (RV) function represents a prognostic marker in patients with corrected congenital heart disease. In up to 80 % of these patients, right branch bundle block (RBBB) exists and leads to asynchronous ventricular contraction.
The aim of this retrospective study was to evaluate the change of RV performance parameters considering delayed RV end-systolic contraction.
RV volumes of 33 patients were assessed twice: 1) not taking account of RBBB (group I), and 2) considering RBBB (group II). According to the RV ejection fraction (EF) for both groups, RV function was classified in different categories (>50 % = normal, 40–50 % = mildly-, 30–40 % = moderately-, <30 % = severely-reduced).
The mean time difference between maximal systolic contraction of the septum and RV free wall was 90.7 ms ± 42.6. Consequently, RV end-systolic volume was significantly decreased in group II (p < 0.001). Accordingly, RV stroke volume and RV EF were significantly higher in group II (p < 0.001). There was also a significant change in the assessment of RV function (p < 0.02).
RBBB induced delayed RV contraction can be detected at CMR. Ignoring the RV physiology in RBBB patients leads to a statistically significant underscoring of RV performance parameters.
• Right branch bundle block leads to an asynchronous ventricular contraction
• In CMR, a delayed right ventricular contraction due to RBBB can be detected
• Ignoring RV physiology in RBBB patients leads to underscoring of RV performance
KeywordsCongenital heart defects Magnetic resonance imaging Bundle-branch block Ventricular ejection fraction Tetralogy of Fallot
The scientific guarantor of this publication is Prof. Dr. Erich Sorantin. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, performed at one institution.
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