Evaluation of right ventricular global longitudinal function in patients with tetralogy of fallot by two-dimensional ultrasound speckle tracking imaging

Abstract

Quantification of right ventricular (RV) volume and function remains a challenge because of RV complex geometry by conventional echocardiography. The purpose of this study was to assess RV global longitudinal function in patients with tetralogy of Fallot (TOF) by 2-dimensional ultrasound speckle tracking imaging (STI). Thirty-eight patients with TOF were enrolled in this study and divided into child group (n=25) and adult group (n=13) according to age. Thirty-eight age- and sex-matched normal subjects were selected as control groups including child control group (n=25) and adult control group (n=13). RV global longitudinal peak systolic strain (GLS), strain rate (GLSR_s), early diastolic strain rate (GLSR_e) and late diastolic strain rate (GLSR_a) were measured in all subjects by STI from the apical 4-chamber view and compared between groups. Furthermore, the main factors affecting the RV global longitudinal functional parameters were assessed. Compared with those in controls, RV GLS, GLSR_s and GLSR_e were significantly reduced in patients with TOF (P<0.05 for all). RV GLSR_s was significantly decreased in adult patients with TOF as compared with that in child patients (P<0.05). There was no significant difference in RV GLS, GLSR_e and GLSR_a between child and adult TOF groups (P>0.05). The diameter of right ventricle, main pulmonary artery and ventricular septum defect had correlations with RV GLSR_s (r₁=−0.490, r₂=0.580, r₃=−0.528, respectively, P<0.05 for all). Tricuspid annular plane peak systolic velocity (Sm) was the independent predictor of RV global strain and strain rate (β₁=0.355, P₁=0.031, β₂=0.307, P₂=0.021). RV global longitudinal function is decreased in patients with TOF, especially in adult patients. STI is a sensitive and accurate technique in RV global functional assessment.

Keywords

echocardiography / tetralogy of Fallot / ventricular function, global, right / 2-dimensional speckle tracking

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