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Updated: Nov 1, 2025
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Ventricular function and dyssynchrony in children with a functional single right ventricle using real time
Shu-Wen Zhong1, Yu-Qi Zhang2, Li-Jun Chen2
1International Department, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Insights
Real-time three-dimensional echocardiography (RT-3DE) can assess ventricular dysfunction and dyssynchrony in single right ventricle (FSRV) patients post-Fontan procedure. RT-3DE underestimates volume but reveals reduced function and increased dyssynchrony in FSRV children.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Congenital Heart Disease
Background:
- Functional single right ventricle (FSRV) presents unique challenges post-Fontan procedure.
- Assessing ventricular systolic dysfunction and dyssynchrony is crucial for FSRV management.
- Real-time three-dimensional echocardiography (RT-3DE) offers potential for non-invasive assessment.
Purpose of the Study:
- To evaluate the feasibility and clinical value of RT-3DE.
- To assess ventricular systolic dysfunction and dyssynchrony in pediatric FSRV patients post-Fontan.
- To compare RT-3DE findings with magnetic resonance imaging (MRI) as a reference standard.
Main Methods:
- Twenty-five FSRV children and 25 healthy controls were studied.
- RT-3DE was used for right ventricular (RV) volume and function analysis.
- RV systolic dyssynchrony indices were calculated and compared between groups.
Main Results:
- RT-3DE measurements underestimated RV volumes compared to MRI.
- FSRV patients exhibited significantly higher dyssynchrony indices and lower global ejection fraction (EF) than controls.
- Tmsv-SD% showed the strongest correlation with MRI-RVEF (r = -0.570, p = 0.003).
Conclusions:
- RT-3DE is a feasible tool for assessing FSRV ventricular function and dyssynchrony.
- FSRV children demonstrate impaired ventricular function and increased dyssynchrony post-Fontan.
- Worsening RV dyssynchrony correlates with overall functional decline after the Fontan operation.
Background:
This study aimed to evaluate the feasibility and clinical value of real time three-dimensional echocardiography (RT-3DE) for assessing ventricular systolic dysfunction and dyssynchrony in children with an functional single right ventricle (FSRV) having undergone the Fontan procedure.
Methods:
Twenty-five children with an FSRV and 25 healthy children were enrolled in our study. RV volume analysis was performed compared with magnetic resonance imaging (MRI) as the reference standard in FSRV patients. The patients were divided into wide and narrow QRS interval groups. Global and regional functions of the RV in three compartments (inflow, body, and outflow) were compared between FSRV and control subjects, including RV systolic dyssynchrony indices of maximal difference of time to minimal volume (Tmsv-Dif), standard deviation of time to minimal volume (Tmsv-SD), maximal difference of time to minimal volume corrected by R-R interval (Tmsv-Dif%), and standard deviation of time to minimal volume corrected by R-R interval (Tmsv-SD%).
Results:
RT-3DE measurements were significantly lower than MRI measurements for RV-EDV, RV-ESV, RV-SV, and RVEF (p < 0.01).Compared with controls, patients with an FRSV had significantly higher dyssynchrony indices and significantly lower global EF in both narrow QRS interval and wide QRS interval groups. Tmsv-SD% was shown to be most strongly correlated with MRI-RVEF (r = -.570, p = 0.003).
Conclusions:
RT-3DE tended to underestimate RV ventricular volume in children with FSRV. Children with an FSRV and either a wide or narrow QRS interval had reduced ventricular function and higher dyssynchrony than normal subjects. Worsening RV dyssynchrony is associated with overall decline in function after the Fontan operation.
