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Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Assessment of right ventricular function in children with congenital heart disease. Doppler tissue imaging
Noor M Noori1, Semira Mehralizadeh, Ali Khaje
1Pediatric Cardiac Research Center, Aliasghar Hospital, Zahedan, Semnan, Iran.
Insights
Doppler tissue imaging (DTI) effectively diagnoses right ventricular dysfunction in children with congenital heart disease (CHD). This non-invasive method shows high accuracy, offering a valuable alternative to cardiac catheterization for assessing these young patients.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Congenital Heart Disease
Background:
- Right ventricular dysfunction is a significant concern in children with congenital heart disease (CHD).
- Accurate and non-invasive assessment methods are crucial for timely diagnosis and management.
- Cardiac catheterization, while definitive, carries risks, especially in unstable pediatric patients.
Purpose of the Study:
- To evaluate the efficacy of Doppler tissue imaging (DTI) in assessing right ventricular dysfunction in pediatric CHD.
- To determine the diagnostic accuracy of the tricuspid annular diastolic velocity Aa/Ea ratio measured by DTI.
Main Methods:
- A case-control study involving 141 children with CHD undergoing cardiac catheterization.
- Measurement of tricuspid annular diastolic velocity Aa/Ea ratio using DTI.
- Comparison of DTI findings with hemodynamic criteria obtained during cardiac catheterization.
Main Results:
- Significant correlation found between DTI-derived Aa/Ea ratio and catheterization hemodynamic data.
- DTI identified right ventricular dysfunction in 77 out of 141 patients (54.6%).
- High diagnostic accuracy for DTI: 95% sensitivity, 98% specificity, 95% PPV, 98% NPV.
Conclusions:
- Doppler tissue imaging (DTI) is a reliable tool for diagnosing right ventricular dysfunction in children with CHD.
- DTI can serve as a non-invasive alternative to cardiac catheterization, particularly for unstable pediatric patients.
- This technique enhances the non-invasive assessment capabilities in pediatric cardiology.
Objective:
To assess right ventricular dysfunction in children with congenital heart disease (CHD) by measurement of tricuspid annular diastolic velocity Aa/Ea ratio by doppler tissue imaging (DTI).
Methods:
A case-control study was performed on 141 children with CHD who were referred to Aliasghar Hospital of Zahedan, Iran for cardiac catheterization from April 2004 to December 2005. Tricuspid inflow velocity (A/E ratio) and Aa/Ea ratio was measured by DTI. Patients were catheterized afterwards. Cumulative data were analyzed by Statistical Package for Social Sciences and evaluated using t-test and correlation.
Results:
There was significant correlation between Aa/Ea ratio by DTI, and hemodynamic criteria derived at catheterization. It was also diagnosed that 77 patients of 141 had right ventricular dysfunction by DTI, whereas 74 of them showed this problem at catheterization. The sensitivity of this method for evaluation of right ventricular dysfunction was 95%, and specificity was 98%. The positive predictive value 95%, and negative predictive value 98% were assessed.
Conclusion:
Finding of this study showed that we can use DTI for diagnosis of right ventricular dysfunction in children with CHD, and it can be used instead of catheterization especially in unstable patients.
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