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Published on: February 3, 2014
Geometry-Related Right Ventricular Systolic Function Assessed by Longitudinal and Radial Right Ventricular
Ikuo Hashimoto1, Kazuhiro Watanabe1
1Department of Pediatrics, Toyama City Hospital, Toyama City, Japan.
Insights
This study in 953 children found that right ventricular stroke volume is linked to longitudinal contraction, not radial motion, in healthy hearts. These findings clarify right ventricular systolic function assessment in pediatric cardiology.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Cardiovascular Physiology
Background:
- Assessing right ventricular (RV) systolic function is crucial in pediatric cardiology.
- Understanding the interplay between RV geometry and contraction patterns is essential for accurate functional evaluation.
- Previous studies have not fully elucidated the relationship between longitudinal and radial RV contractions and RV stroke volume in healthy children.
Purpose of the Study:
- To evaluate geometry-related right ventricular (RV) systolic function under normal hemodynamics.
- To assess longitudinal and radial RV contractions and their relationship with RV stroke volume in healthy children.
- To investigate how RV geometry influences contraction patterns.
Main Methods:
- Examined 953 healthy children using M-mode and Doppler echocardiography.
- Measured tricuspid annular plane systolic excursion (TAPSE), RV anterior wall displacement (RVWD), and RV/left ventricular diameter ratio (RV/LV).
- Calculated z-values for TAPSE, RVWD, RV/LV ratio, and standardized RV stroke volume (z-RVSV).
Main Results:
- z-TAPSE showed weak negative correlations with z-RVWD and z-RV/LV.
- z-RV/LV correlated positively with z-RVWD.
- z-RVSV was significantly correlated only with z-TAPSE (longitudinal motion), independent of radial motion.
Conclusions:
- Right ventricular stroke volume in healthy children is primarily related to longitudinal RV motion.
- Radial RV motion, despite increasing with RV dilatation, does not correlate with RV stroke volume under normal conditions.
- RV contraction patterns may vary based on RV geometry and hemodynamic conditions.
Abstract:
The aim of our study was to evaluate the geometry-related right ventricular (RV) systolic function under normal hemodynamics by assessing the longitudinal and the radial RV contractions in children. We examined 953 healthy children. We measured tricuspid annular plane systolic excursion (TAPSE), RV anterior wall displacement from the interventricular septum (RVWD), and RV to left ventricular diameter ratio (RV/LV ratio) using M-mode echocardiography. The z-values were calculated as geometrical parameters of the TAPSE (z-TAPSE), the RVWD (z-RVWD), and the RV/LV ratio (z-RV/LV). The RV stroke volume (RVSV) was measured using Doppler echocardiography and standardized using the z-value (z-RVSV). The z-TAPSE was no or weakly negatively correlated with both the z-RVWD (r = -0.18, P < 0.0001) and the z-RV/LV (r = -0.12, P < 0.0001). In contrast, the z-RV/LV correlated positively with the z-RVWD (r = 0.61, P < 0.0001). The z-RVSV correlated only with the z-TAPSE (r = 0.30, P < 0.0001). Although the radial RV motion increases with the progression of RV dilatation, the RVSV is not associated with radial RV motion. In contrast, the RVSV relates to the longitudinal RV motion independently of the radial RV motion under the normal physiological condition. We presume that the RV contraction patterns change related to the RV geometry under various hemodynamic conditions.
