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Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Right ventricular function in patients with Eisenmenger syndrome
Alexander Van De Bruaene1, Pieter De Meester, Jens-Uwe Voigt
1University Hospitals Leuven, Belgium. Alexander.vandebruaene@uzleuven.be
The American Journal of Cardiology
|January 27, 2012
Summary
Right ventricular dysfunction, measured by tricuspid annular plane systolic excursion (TAPSE), is linked to poorer outcomes in Eisenmenger syndrome patients. Pre-tricuspid shunts show distinct RV responses and dimensions compared to post-tricuspid shunts.
Area of Science:
- Cardiology
- Echocardiography
- Pulmonary Hypertension
Background:
- Eisenmenger syndrome is a complex congenital heart disease with significant morbidity.
- Right ventricular (RV) dysfunction is a key concern in Eisenmenger syndrome.
- Tricuspid annular plane systolic excursion (TAPSE) is a common echocardiographic measure of RV function.
Purpose of the Study:
- To determine if RV dysfunction (assessed by TAPSE) predicts adverse outcomes in Eisenmenger syndrome.
- To identify variables associated with RV dysfunction in these patients.
- To compare characteristics and RV responses among different types of congenital heart shunts (pretricuspid, post-tricuspid, combined).
Main Methods:
- Retrospective and prospective analysis of patients from the Belgian Eisenmenger registry.
- Echocardiography including TAPSE measurements.
- Cox regression analysis for outcome prediction (mortality, transplantation, hospitalization).
- Comparative and bivariate analyses for patient characteristics and shunt types.
Main Results:
- Lower TAPSE was significantly associated with adverse outcomes (all-cause mortality, transplantation, cardiopulmonary hospitalization) in Eisenmenger syndrome patients.
- Patients with pretricuspid shunt lesions were older and had larger atrial and RV dimensions compared to those with post-tricuspid lesions.
- Lower TAPSE correlated with the presence of pulmonary artery thrombosis.
Conclusions:
- RV dysfunction, as indicated by reduced TAPSE, is a significant predictor of worse outcomes in Eisenmenger syndrome.
- Differences in RV dimensions and atrial sizes exist between pretricuspid and post-tricuspid shunt types, suggesting varied RV remodeling.
- Pulmonary artery thrombosis is linked to more severe RV dysfunction.
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