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Usefulness of a New Transthoracic Echocardiography Score to Assess Right Ventricular Volumes in Patients with Repaired Tetralogy of Fallot

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Abstract

Quantification of right ventricular (RV) volumes is essential in the follow-up of patients with a repaired tetralogy of Fallot (TOF). Cardiac magnetic resonance imaging (MRI) is the gold standard for RV assessment. However, given its cost and availability, the systematic use of MRI for serial longitudinal follow-up is limited. Herein, we examined the utility of a new two-dimensional (2D) transthoracic echocardiography (TTE) score (the RVDi score), which includes a compilation of 2D RV dimensions indexed to the body surface area, for predicting MRI-derived RV end-diastolic volume (RVEDV) in patients with a repaired TOF. Using our congenital heart clinic database, we retrospectively included 29 adult patients with a repaired TOF between February 2015 and July 2019. The 2D TTE RVDi score was compared with the MRI-derived RVEDV. Sensitivity and specificity values for predicting an RVEDVi > 150 ml/m2 were calculated. The TTE RVDi score was highly correlated (r = 0.944) with MRI RVEDVi. A cut-off RVDi score set at 120 mm/m2 predicted an RVEDVi > 150 ml/m2 with a sensitivity of 83% and specificity of 94%. Use of a simple echocardiographic score based on indexed RV dimensions from 2D standard TTE imaging may complement the assessment of RV volumes in TOF patients.

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Data availability

Data are available on request to corresponding author.

Code availability

Software application are precised in the article.

Abbreviations

FAC:

Fractionnal area change

ICC:

Intraclass correlation coefficient

MRI:

Magnetic resonance imaging

PR:

Pulmonary regurgitation

PV:

Pulmonary valve

ROC:

Receiver operating characteristic

RV:

Right ventricle

RVD:

Right ventricular dimensions

RVDi:

Indexed right ventricular dimensions

RVEDV:

Right ventricle end-diastolic volume

RVEDVi:

Right ventricle end-diastolic volume indexed

RVEF:

Right ventricle ejection fraction

RVESV:

Right ventricle end-systolic volume

RVESVi:

Indexed right ventricle end-systolic volume

RVOT:

Right ventricular outflow tract

S′:

Tricuspid systolic peak velocity by tissue doppler imaging of tricuspid annulus

Se:

Sensitivity

Sp:

Specificity

TAPSE:

Tricuspid annular plane systolic excursion

TOF:

Tetralogy of Fallot

TTE:

Transthoracic echocardiography

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Acknowledgements

We thank Edanz (https://www.edanz.com/ac) for editing a draft of this manuscript.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Radiology, CHU de CAEN, 14000, Caen, France

    Thibault Fages, Frédéric Seita & Michèle Hamon

  2. Department of Cardiology, Caen University, CHU de CAEN, Avenue Cote de Nacre, 14000, Caen, France

    Fabien Labombarda & Pascale Maragnes

  3. UNICAEN, 14000, Caen, France

    Fabien Labombarda & Michèle Hamon

Authors
  1. Thibault Fages
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  2. Fabien Labombarda
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  3. Pascale Maragnes
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  4. Frédéric Seita
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  5. Michèle Hamon
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Contributions

TF: Data interpretation (MRI studies), statistics, drafting article and approval of article. FL: concept, data collection and data interpretation (TTE studies), statistics, critical revision of article and approval of article. PM: data collection and data interpretation (TTE studies), approval of article. FS: concept, data interpretation (MRI studies), approval of article. MH: data collection and interpretation (MRI studies), critical revision and approval of article.

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Correspondence to Fabien Labombarda.

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Authors have no competing interests to declare.

Ethical approval

the present study was approved by our local ethics and health research committee (CLERS, clers@unicaen.fr, study ID: 15.99).

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Due to the retrospective study design and type of research, informed consent requirements were waived.

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Fages, T., Labombarda, F., Maragnes, P. et al. Usefulness of a New Transthoracic Echocardiography Score to Assess Right Ventricular Volumes in Patients with Repaired Tetralogy of Fallot. Pediatr Cardiol 43, 171–180 (2022). https://doi.org/10.1007/s00246-021-02711-0

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  • DOI: https://doi.org/10.1007/s00246-021-02711-0

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