Multi-modality imaging of the systemic right ventricle in congenital heart disease

Area of Science:

• Cardiology
• Medical Imaging
• Congenital Heart Disease

Background:

• Lifelong surveillance of adults with congenital heart disease (ACHD) necessitates comprehensive imaging of the systemic right ventricle (sRV).
• sRV assessment is challenging due to complex morphology and differences from the systemic left ventricle.
• Current imaging practices often rely on qualitative assessments, with standardized quantitative parameters still under development.

Purpose of the Study:

• To review the challenges and available imaging tools for evaluating the sRV in patients with complete transposition of the great arteries (TGA) and congenitally corrected transposition of the great arteries (ccTGA).
• To highlight the role of advanced echocardiographic techniques in sRV assessment.

Main Methods:

• Review of current literature on cardiovascular imaging modalities for sRV evaluation.
• Discussion of cardiac magnetic resonance (CMR) as the gold standard.
• Exploration of echocardiography, including speckle tracking echocardiography (STE) and three-dimensional echocardiography (3DE).

Main Results:

• Cardiac magnetic resonance (CMR) is considered the gold standard for sRV imaging.
• Qualitative assessment of sRV systolic function is common in clinical practice.
• Advanced echocardiographic techniques, STE and 3DE, offer improved insights into sRV function.

Conclusions:

• Optimal lifelong surveillance of sRV in ACHD requires a structured imaging approach.
• While CMR is the gold standard, advanced echocardiography provides valuable tools for sRV assessment.
• Further morphometric and mechanistic studies are needed to validate standardized quantitative parameters and reference ranges for sRV.