Exploring three-dimensional right ventricular shape and function in Tetralogy of Fallot patients

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Tetralogy of Fallot (ToF) is a common congenital heart defect often leading to right ventricular (RV) dysfunction.
• Three-dimensional echocardiography (3DE) provides enhanced RV volume and function assessment.
• Accurate RV geometry evaluation is crucial for managing ToF patients.

Purpose of the Study:

• To compare 3DE-derived RV shape and function parameters between ToF patients and healthy controls.
• To validate a custom software tool for quantifying RV morphology and deformation.
• To identify key RV regions affected by remodeling in ToF.

Main Methods:

• Acquired 3DE RV datasets from 50 ToF patients and 50 healthy controls.
• Segmented RVs using commercial software and processed with custom software for mean curvature (MC), area strain (AS), and longitudinal strain (LS).
• Analyzed global and regional RV parameters, focusing on curvature and strain in predefined segments.

Main Results:

• Curvature analysis highlighted the posterior boundary and apex as key regions of RV remodeling in ToF.
• Observed septal flattening and decreased concavity in ToF patients.
• Found significantly reduced global RV AS in ToF, with the greatest impairment at the apex.

Conclusions:

• The custom software enables comprehensive RV analysis from 3DE.
• Curvature analysis offers a sensitive measure of RV remodeling in ToF.
• Detailed RV strain analysis provides insight into regional dysfunction, potentially improving clinical decision-making for ToF.