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Updated: Nov 21, 2025
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
INSTRUMENTAL MARKERS OF THE RIGHT VENTRICLE FUNCTIONAL CONDITION WITH TISSUE DOPPLER IN CHILDREN WITH TETRALOGY OF
Veronika M Dudnyk1, Olha O Zborovska1, Yuilia V Vyzhga1
1NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE.
Insights
Tissue Doppler imaging reveals right ventricle myocardial dysfunction in children after tetralogy of Fallot repair. Key markers include reduced tricuspid annular plane systolic excursion (TAPSE) and peak myocardial velocities (S`, IVV), especially with severe pulmonary regurgitation.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Tetralogy of Fallot (ToF) surgical correction is standard but can lead to right ventricle (RV) dysfunction.
- Accurate evaluation of RV function post-correction is crucial for patient management.
Purpose of the Study:
- To enhance the assessment of RV functional condition in children post-ToF repair.
- To identify instrumental markers of myocardial dysfunction using Tissue Doppler imaging.
Main Methods:
- Examined 35 children (3-17 years) post-ToF surgical correction.
- Utilized Tissue Doppler echocardiography to measure RV myocardial velocities (S`, E`, A`), TAPSE, E/E` ratio, IVV, and IVRT.
- Assessed severity of pulmonary regurgitation.
Main Results:
- Children exhibited reduced TAPSE, S`, and IVV compared to healthy controls.
- Severe pulmonary regurgitation correlated with higher likelihood of RV systolic dysfunction (decreased TAPSE, S`, IVV).
- Diastolic dysfunction was indicated by decreased E` and A` velocities, increased E/E` ratio, and prolonged IVRT.
Conclusions:
- Tissue Doppler indices of myocardial velocities are valuable markers of RV dysfunction in post-ToF repair children.
- These echocardiographic parameters provide objective data beyond clinical symptoms of heart failure.
Objective:
The aim: To improve efficacy of the right ventricle functional condition evaluation in children with tetralogy of Fallot after surgical correction by estimation of instrumental markers of myocardial dysfunction.
Patients And Methods:
Materials and methods: We completely examined 35 children with tetralogy of Fallot after their surgical correction at the age of 3 - 17 years. For all the patients was presented tissue doppler. We evaluated peak myocardial velocities of right ventrical in different phases of the heart cycle (S, E`, A`), tricuspid annular plane systolic excursion (TAPSE), diastolic myocardial velocities ratio (E/E`), peak myocardial velocity during isovolumic contraction (IVV), isovolumic relaxation time (IVRT).
Results:
Results: All children of the study group had pulmonary insufficiency of different severity with main predominance of mild pulmonary regurgitation (20 patients, 57,14±8,36 %). Children with tetralogy of Fallot after surgical correction were admitted with: decreased TAPSE up to 1,39±0,28 cm, decreased S` up to 8,00±1,90 cm/s, and decreased IVV up to 5,69±0,95 cm/s that is significantly lower results of the healthy children. Severe pulmonary regurgitation usually followed by high chances of the right ventricle systolic dysfunction, exactly with: decresed TAPSE<1,5 cm (OR=0,500; 95% CI 0,323 - 0,775), S`<8,1 cm/s (OR=0,600; 95% CI 0,420 - 0,858) and IVV<5,9 cm/s (OR=0,250; 95% CI 0,117 - 0,534). As well we admitted significant decline of the velocities in earl and end diastole periods to compare with the results of the control group (E`= 12,11±1,22, A`= 4,56±0,92 cm/s (Р=0,009 and P=0.0002)), boost of the E/E` ratio - 7,96±2,33 (P=0.01) and decline of the RV IVRT up to 43,49±6,04 ms (P=0.017). Severe pulmonary regurgitation followed by high chances of the right ventricle systolic dysfunction development with TAPSE <1,5 cm (OR=0,500; 95% CI 0,323 - 0,775), S`<8,1 cm/s (OR=0,600; 95% CI 0,420 - 0,858) and IVV<5,9 cm/s (OR=0,250; 95% CI 0,117 - 0,534). As well we noticed high chances of the E/E`ratio > 6,0 in 1,5 times (95% CI 1,072 - 1,903) and decreased E` <12,2 cm/s (OR=0,200; 95% CI 0,083 - 0,481).
Conclusion:
Conclusions: Apart of clinical symptoms of the heart failure in children with tetralogy of Fallot after surgical correction markers of the right ventricle myocardial dysfunction are presented by indices of myocardial velocities, received during tissue doppler in different phases of the heart cycle.
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