[Tissue Doppler imaging in the assessment of right ventricular function in congenital heart disease. Correlation with...

The noninvasive evaluation of right ventricular function is difficult, especially in postoperative complex congenital heart disease due to the special right ventricular geometry. The right ventricular dysfunction is a key factor in morbidity and mortality and in the determination of the necessity of reoperation.

To report the author's experiences of 133 TDI investigations. Pts age: 14 days-20 yrs, mean 12,4 yrs. To assess right ventricular function TDI investigations were performed for "systemic right ventricular" function in transposition of great arteries after Senning operation (Group I.21 TDI in 17 pts) and after reconstruction of Tetralogy of Fallot (Group II, 21 pts).

RV tricuspid anulus systolic velocity (Sy) and early diastolic velocity (E') were measured from Doppler inflow the E wave peak velocity, and the E/E' ratio was calculated. The deviation of these TDI velocities from normal values were analyzed and the correlation with RV ejection fraction was measured by MRI.

In Group I we found significant differences from normal population Sy 9.3 +/- 3.7 cm/s vs. 14.2 +/- 2.3, E' 12.8 +/- 4.7 cm/s vs. 16.7 +/- 2.8 cm/s, E/E' 7.2 +/- 4.6 vs. 3.7 +/- 1.4. Sy TDI velocity and E/E' ratio showed good correlation with RV EF measured by MRI ( p > 0.001). In Group II Sy velocity was decreased: 11.3 +/- 4.3 cm/s and showed also good correlation with MRI EF ( p > 0.001).

TDI for RV function analysis is recommended in congenital heart disease and also proposed in addition to other methods. Due to experience with MRI, reliable data can be collected for the postoperative pts, to decide the correct time of redo operation.