Effects of right ventricular hemodynamic burden on Intraventricular flow in tetralogy of fallot

An echocardiographic contrast particle imaging velocimetry study

Shelby Kutty, Ling Li, David A. Danford, Helene Houle, Saurabh Datta, Joel Mancina, Yunbin Xiao, Gianni Pedrizzetti, Thomas R. Porter

Research output: Contribution to journalArticle

Abstract

Background The purpose of this investigation was to test the hypothesis that flow patterns in the right ventricle are abnormal in patients with repaired tetralogy of Fallot (TOF). High-resolution echocardiographic contrast particle imaging velocimetry was used to investigate rotation intensity and kinetic energy dissipation of right ventricular (RV) flow in patients with TOF compared with normal controls.

Methods Forty-one subjects (16 with repaired TOF and varying degrees of RV dilation and 25 normal controls) underwent prospective contrast imaging using the lipid-encapsulated microbubble (Definity) on Sequoia systems. A mechanical index of 0.4, three-beat high-frame rate (>60 Hz) captures, and harmonic frequencies were used. Rotation intensity and kinetic energy dissipation of flow in the right and left ventricles were studied (Hyperflow). Ventricular volumes and ejection fractions in all subjects were derived from same-day cardiac magnetic resonance (CMR).

Results Measurable planar maps were obtained for the left ventricle in 14 patients and the right ventricle in 10 patients among those with TOF and for the left ventricle in 23 controls and the right ventricle in 21 controls. Compared with controls, the TOF group had higher RV indexed end-diastolic volumes (117.8 ± 25.5 vs 88 ± 15.4 mL/m2, P <.001) and lower RV ejection fractions (44.6 ± 3.6% vs 51.8 ± 3.6%, P <.001). Steady-streaming (heartbeat-averaged) flow rotation intensities were higher in patients with TOF for the left ventricle (0.4 ± 0.13 vs 0.29 ± 0.08, P =.012) and the right ventricle (0.53 ± 0.15 vs 0.26 ± 0.12, P <.001), whereas kinetic energy dissipation in TOF ventricles was lower (for the left ventricle, 0.51 ± 0.29 vs 1.52 ± 0.69, P <.001; for the right ventricle, 0.4 ± 0.24 vs 1.65 ± 0.91, P <.001).

Conclusions It is feasible to characterize RV and left ventricular flow parameters and planar maps in adolescents and adults with repaired TOF using echocardiographic contrast particle imaging velocimetry. Intraventricular flow patterns in the abnormal and/or enlarged right ventricle in patients with TOF differ from those in normal young adults. The rotation intensity and energy dissipation trends in this investigation suggest that they may be quantitative markers of RV and left ventricular compliance abnormalities in patients with repaired TOF. This hypothesis merits further investigation.

Original languageEnglish (US)
Pages (from-to)1311-1318
Number of pages8
JournalJournal of the American Society of Echocardiography
Volume27
Issue number12
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Tetralogy of Fallot
Rheology
Heart Ventricles
Hemodynamics
Stroke Volume
Sequoia
Microbubbles
Patient Rights
Compliance
Dilatation
Young Adult
Magnetic Resonance Spectroscopy

Keywords

  • Cardiac blood flow
  • Congenital heart surgery
  • Fallot
  • Tetralogy of
  • Two-dimensional echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Effects of right ventricular hemodynamic burden on Intraventricular flow in tetralogy of fallot : An echocardiographic contrast particle imaging velocimetry study. / Kutty, Shelby; Li, Ling; Danford, David A.; Houle, Helene; Datta, Saurabh; Mancina, Joel; Xiao, Yunbin; Pedrizzetti, Gianni; Porter, Thomas R.

In: Journal of the American Society of Echocardiography, Vol. 27, No. 12, 01.01.2014, p. 1311-1318.

Research output: Contribution to journalArticle

Kutty, Shelby ; Li, Ling ; Danford, David A. ; Houle, Helene ; Datta, Saurabh ; Mancina, Joel ; Xiao, Yunbin ; Pedrizzetti, Gianni ; Porter, Thomas R. / Effects of right ventricular hemodynamic burden on Intraventricular flow in tetralogy of fallot : An echocardiographic contrast particle imaging velocimetry study. In: Journal of the American Society of Echocardiography. 2014 ; Vol. 27, No. 12. pp. 1311-1318.
@article{7000e7cee05841b387720c4323c64ecb,
title = "Effects of right ventricular hemodynamic burden on Intraventricular flow in tetralogy of fallot: An echocardiographic contrast particle imaging velocimetry study",
abstract = "Background The purpose of this investigation was to test the hypothesis that flow patterns in the right ventricle are abnormal in patients with repaired tetralogy of Fallot (TOF). High-resolution echocardiographic contrast particle imaging velocimetry was used to investigate rotation intensity and kinetic energy dissipation of right ventricular (RV) flow in patients with TOF compared with normal controls.Methods Forty-one subjects (16 with repaired TOF and varying degrees of RV dilation and 25 normal controls) underwent prospective contrast imaging using the lipid-encapsulated microbubble (Definity) on Sequoia systems. A mechanical index of 0.4, three-beat high-frame rate (>60 Hz) captures, and harmonic frequencies were used. Rotation intensity and kinetic energy dissipation of flow in the right and left ventricles were studied (Hyperflow). Ventricular volumes and ejection fractions in all subjects were derived from same-day cardiac magnetic resonance (CMR).Results Measurable planar maps were obtained for the left ventricle in 14 patients and the right ventricle in 10 patients among those with TOF and for the left ventricle in 23 controls and the right ventricle in 21 controls. Compared with controls, the TOF group had higher RV indexed end-diastolic volumes (117.8 ± 25.5 vs 88 ± 15.4 mL/m2, P <.001) and lower RV ejection fractions (44.6 ± 3.6{\%} vs 51.8 ± 3.6{\%}, P <.001). Steady-streaming (heartbeat-averaged) flow rotation intensities were higher in patients with TOF for the left ventricle (0.4 ± 0.13 vs 0.29 ± 0.08, P =.012) and the right ventricle (0.53 ± 0.15 vs 0.26 ± 0.12, P <.001), whereas kinetic energy dissipation in TOF ventricles was lower (for the left ventricle, 0.51 ± 0.29 vs 1.52 ± 0.69, P <.001; for the right ventricle, 0.4 ± 0.24 vs 1.65 ± 0.91, P <.001).Conclusions It is feasible to characterize RV and left ventricular flow parameters and planar maps in adolescents and adults with repaired TOF using echocardiographic contrast particle imaging velocimetry. Intraventricular flow patterns in the abnormal and/or enlarged right ventricle in patients with TOF differ from those in normal young adults. The rotation intensity and energy dissipation trends in this investigation suggest that they may be quantitative markers of RV and left ventricular compliance abnormalities in patients with repaired TOF. This hypothesis merits further investigation.",
keywords = "Cardiac blood flow, Congenital heart surgery, Fallot, Tetralogy of, Two-dimensional echocardiography",
author = "Shelby Kutty and Ling Li and Danford, {David A.} and Helene Houle and Saurabh Datta and Joel Mancina and Yunbin Xiao and Gianni Pedrizzetti and Porter, {Thomas R.}",
year = "2014",
month = "1",
day = "1",
doi = "10.1016/j.echo.2014.09.016",
language = "English (US)",
volume = "27",
pages = "1311--1318",
journal = "Journal of the American Society of Echocardiography",
issn = "0894-7317",
publisher = "Mosby Inc.",
number = "12",

}

TY - JOUR

T1 - Effects of right ventricular hemodynamic burden on Intraventricular flow in tetralogy of fallot

T2 - An echocardiographic contrast particle imaging velocimetry study

AU - Kutty, Shelby

AU - Li, Ling

AU - Danford, David A.

AU - Houle, Helene

AU - Datta, Saurabh

AU - Mancina, Joel

AU - Xiao, Yunbin

AU - Pedrizzetti, Gianni

AU - Porter, Thomas R.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background The purpose of this investigation was to test the hypothesis that flow patterns in the right ventricle are abnormal in patients with repaired tetralogy of Fallot (TOF). High-resolution echocardiographic contrast particle imaging velocimetry was used to investigate rotation intensity and kinetic energy dissipation of right ventricular (RV) flow in patients with TOF compared with normal controls.Methods Forty-one subjects (16 with repaired TOF and varying degrees of RV dilation and 25 normal controls) underwent prospective contrast imaging using the lipid-encapsulated microbubble (Definity) on Sequoia systems. A mechanical index of 0.4, three-beat high-frame rate (>60 Hz) captures, and harmonic frequencies were used. Rotation intensity and kinetic energy dissipation of flow in the right and left ventricles were studied (Hyperflow). Ventricular volumes and ejection fractions in all subjects were derived from same-day cardiac magnetic resonance (CMR).Results Measurable planar maps were obtained for the left ventricle in 14 patients and the right ventricle in 10 patients among those with TOF and for the left ventricle in 23 controls and the right ventricle in 21 controls. Compared with controls, the TOF group had higher RV indexed end-diastolic volumes (117.8 ± 25.5 vs 88 ± 15.4 mL/m2, P <.001) and lower RV ejection fractions (44.6 ± 3.6% vs 51.8 ± 3.6%, P <.001). Steady-streaming (heartbeat-averaged) flow rotation intensities were higher in patients with TOF for the left ventricle (0.4 ± 0.13 vs 0.29 ± 0.08, P =.012) and the right ventricle (0.53 ± 0.15 vs 0.26 ± 0.12, P <.001), whereas kinetic energy dissipation in TOF ventricles was lower (for the left ventricle, 0.51 ± 0.29 vs 1.52 ± 0.69, P <.001; for the right ventricle, 0.4 ± 0.24 vs 1.65 ± 0.91, P <.001).Conclusions It is feasible to characterize RV and left ventricular flow parameters and planar maps in adolescents and adults with repaired TOF using echocardiographic contrast particle imaging velocimetry. Intraventricular flow patterns in the abnormal and/or enlarged right ventricle in patients with TOF differ from those in normal young adults. The rotation intensity and energy dissipation trends in this investigation suggest that they may be quantitative markers of RV and left ventricular compliance abnormalities in patients with repaired TOF. This hypothesis merits further investigation.

AB - Background The purpose of this investigation was to test the hypothesis that flow patterns in the right ventricle are abnormal in patients with repaired tetralogy of Fallot (TOF). High-resolution echocardiographic contrast particle imaging velocimetry was used to investigate rotation intensity and kinetic energy dissipation of right ventricular (RV) flow in patients with TOF compared with normal controls.Methods Forty-one subjects (16 with repaired TOF and varying degrees of RV dilation and 25 normal controls) underwent prospective contrast imaging using the lipid-encapsulated microbubble (Definity) on Sequoia systems. A mechanical index of 0.4, three-beat high-frame rate (>60 Hz) captures, and harmonic frequencies were used. Rotation intensity and kinetic energy dissipation of flow in the right and left ventricles were studied (Hyperflow). Ventricular volumes and ejection fractions in all subjects were derived from same-day cardiac magnetic resonance (CMR).Results Measurable planar maps were obtained for the left ventricle in 14 patients and the right ventricle in 10 patients among those with TOF and for the left ventricle in 23 controls and the right ventricle in 21 controls. Compared with controls, the TOF group had higher RV indexed end-diastolic volumes (117.8 ± 25.5 vs 88 ± 15.4 mL/m2, P <.001) and lower RV ejection fractions (44.6 ± 3.6% vs 51.8 ± 3.6%, P <.001). Steady-streaming (heartbeat-averaged) flow rotation intensities were higher in patients with TOF for the left ventricle (0.4 ± 0.13 vs 0.29 ± 0.08, P =.012) and the right ventricle (0.53 ± 0.15 vs 0.26 ± 0.12, P <.001), whereas kinetic energy dissipation in TOF ventricles was lower (for the left ventricle, 0.51 ± 0.29 vs 1.52 ± 0.69, P <.001; for the right ventricle, 0.4 ± 0.24 vs 1.65 ± 0.91, P <.001).Conclusions It is feasible to characterize RV and left ventricular flow parameters and planar maps in adolescents and adults with repaired TOF using echocardiographic contrast particle imaging velocimetry. Intraventricular flow patterns in the abnormal and/or enlarged right ventricle in patients with TOF differ from those in normal young adults. The rotation intensity and energy dissipation trends in this investigation suggest that they may be quantitative markers of RV and left ventricular compliance abnormalities in patients with repaired TOF. This hypothesis merits further investigation.

KW - Cardiac blood flow

KW - Congenital heart surgery

KW - Fallot

KW - Tetralogy of

KW - Two-dimensional echocardiography

UR - http://www.scopus.com/inward/record.url?scp=84919417753&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84919417753&partnerID=8YFLogxK

U2 - 10.1016/j.echo.2014.09.016

DO - 10.1016/j.echo.2014.09.016

M3 - Article

VL - 27

SP - 1311

EP - 1318

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

SN - 0894-7317

IS - 12

ER -