Regional dysfunction of the right ventricular outflow tract reduces the accuracy of Doppler tissue imaging assessment of global right ventricular systolic function in XXXX with repaired tetralogy of Fallot.

@entity1 @entity409 @entity64 @entity3585
BACKGROUND: The influence of regional right ventricular (RV) dysfunction on the accuracy of Doppler tissue imaging (DTI) assessment of global RV function is unknown. The objective of this study was to determine the effect of regional dysfunction of the @entity3585 ( @entity3585 ) on the correlations between RV DTI indices and cardiac magnetic resonance (CMR) measurements of global RV function in @entity1 with repaired tetralogy of Fallot. METHODS: Consecutive @entity1 with repaired tetralogy of Fallot who underwent echocardiography with DTI of the right ventricle and CMR within 4 weeks of each other were retrospectively analyzed. RV DTI measurements were obtained from the lateral wall at the level of the tricuspid valve annulus. CMR measurements included end-diastolic and end-systolic volumes, @entity64 volume, and ejection fraction (EF) of the entire right ventricle and measured separately for the RV sinus and @entity3585 segments. RESULTS: The median age of the 51 @entity1 included was 19 years (range, 9.7-71.6 years), and the median interval between echocardiography and CMR was 0 days. The mean RV free wall peak S', isovolumic acceleration, and global, sinus, and @entity3585 EFs were 8.4    2.0 cm/s, 102    37 cm/s(2), and 46.1    9.8%, 47.9    9.9%, and 33    13.1%, respectively. The correlation between peak S' and global RV EF was weak (r  = 0.23) in @entity1 with @entity409 ( @entity3585 EF <30%) but higher (r  = 0.66) in those with @entity3585 EFs >= 30%. Peak S' >= 8.4 cm/s (area under the receiver operating characteristic curve, 0.77) and isovolumic acceleration >= 95 cm/s(2) (area under the receiver operating characteristic curve, 0.68) best discriminated between @entity1 with global RV EFs >45% and <45%. CONCLUSIONS: In this group of @entity1 with repaired TOF, RV DTI indices showed reasonable correlation with CMR-derived global RV EF, but this correlation was substantially weaker in those with moderate and severe dysfunction of the @entity3585 . Peak S' <8.4 cm/s and isovolumic acceleration <95cm/s(2) by DTI should prompt an evaluation of RV function by CMR.
