Longitudinal systolic ventricular interaction in pediatric and young adult patients with TOF: A cardiac magnetic resonance and M-mode echocardiographic study

Martin Koestenberger, William Ravekes, Bert Nagel, Alexander Avian, Bernd Heinzl, Peter Fritsch, Erich Sorantin, Gerhard Cvirn, Thomas Rehak, Andreas Gamillscheg

Research output: Contribution to journalArticlepeer-review

Abstract

Aim of this prospective study was to evaluate longitudinal systolic left ventricular (LV)-right ventricular (RV) interaction using M-mode compared to magnetic resonance imaging (MRI) data in 146 pediatric and adults with operated tetralogy of Fallot (TOF). We determined biventricular measures of longitudinal M-mode echocardiography [i.e. tricuspid annular plane systolic excursion (TAPSE); the mitral annular plane systolic excursion (MAPSE)] compared to longitudinal function parameters using MRI. M-mode data were compared to established normal z-score values. We found a good correlation between MAPSE and LVEF values (r = 0.788; p < 0.001). Correlations between MRI derived MAPSE and M-mode guided MAPSE (r = 0.879, p < 0.001), and between MRI derived TAPSE and M-mode guided TAPSE were significant (r = 0.780, p < 0.001). While the LVEF was normal in patients with a normal RVEF, the LVEF was decreased in patients with significantly reduced RVEF. Patients with a significantly dilated RV (RVEDVi > 150 ml/m2) showed a significantly reduced mean MAPSE of 1.30 ± 0.26 cm. LV longitudinal function decreases below -2 SD of normal MAPSE z-score values after a mean of 22 postoperative years. Our data confirm progressive adverse RV-LV interaction in the long-term follow-up of TOF. We show that simple M-mode measurement of the longitudinal LV function (i.e. MAPSE) is a sufficient surrogate for estimation of LVEF. Therefore determination of the MAPSE is a helpful additional tool for LV systolic function assessment late after TOF repair.

Original languageEnglish (US)
Pages (from-to)1707-1715
Number of pages9
JournalInternational Journal of Cardiovascular Imaging
Volume29
Issue number8
DOIs
StatePublished - Dec 1 2013

Keywords

  • M-mode
  • Magnetic resonance imaging
  • Mitral annular plane systolic excursion
  • Tetralogy of Fallot
  • Tricuspid annular plane systolic excursion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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