Angiocardiographic Pressure Volume Loops in the Analysis of Right Ventricular Function after Repair of Tetralogy of Fallot

Uebing, Anselm; Fischer, G.; Schmiel, F. K.; Onnasch, D. G. W.; Scheewe, Jens; Kramer, Hans‐Heiner

doi:10.1007/s10554-005-2102-5

Cited by 8 publications

(5 citation statements)

References 12 publications

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“…The peak ejection rate and peak filling rate were calculated from the first derivative of RV volume vs. time curve . The peak negative derivative during RV systole was considered the peak ejection rate.…”

Section: Methodsmentioning

confidence: 99%

“…The peak ejection rate and peak filling rate were calculated from the first derivative of RV volume vs. time curve. 24,[30][31][32] The peak negative derivative during RV systole was considered the peak ejection rate. Similarly, the peak positive derivative during RV diastole was considered the peak filling rate.…”

Section: Ejection Fraction Stroke Volume End Diastolic Volumementioning

confidence: 99%

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Energy Transfer Ratio as a Metric of Right Ventricular Efficiency in Repaired Congenital Heart Disease

et al. 2013

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We determined that the patients had inefficient RV-PA physiology due to a combination of RV dilatation with pulmonary regurgitation and RV outflow obstruction leading to an elevated end-systolic pressure. Using coupled magnetic resonance imaging and invasive pressure measurements, eMPA is determined to be a sensitive energy-based end point for measuring RV-PA efficiency. It may serve as a diagnostic end point to optimize timing of intervention.

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Section: Methodsmentioning

confidence: 99%

Section: Ejection Fraction Stroke Volume End Diastolic Volumementioning

confidence: 99%

Energy Transfer Ratio as a Metric of Right Ventricular Efficiency in Repaired Congenital Heart Disease

et al. 2013

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“…Besides, there is another paper in this volume that is based on angiographic volume determination [2]. It describes right ventricular function after repair of tetralogy of Fallot using not only end-diastolic and end-systolic volumes but also the volume curve over a complete cardiac cycle.…”

mentioning

confidence: 99%

“…The last feature would optimise contour drawing in cases where it is difficult to confine the ventricular silhouette from other opacified cardiac structures, especially when a late beat post an extrasystole is evaluated. To our experience, complete automatic border recognition leads seldom to satisfying results, whereas it can help to confine all the contours between the end-diastolic and end-systolic contours in case that a frame by frame analysis is desired [2].…”

mentioning

confidence: 99%

“…Both cited papers [1,2] on quantitative angiographic evaluation of the right ventricle recommend the use of analytical (or geometrical) calibration utilising an advantage inherent to a biplane multi-axial system: The biplane imaging geometry may be used to calculate the magnification at each point that can be identified in both projections. In its simplest case, the analytical calibration technique assumes the object to be located at the common isocentre of gantry.…”

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Angiographic Determination of Right Ventricular Volumes

Onnasch

Fischer

Kramer

2005

Int J Cardiovasc Imaging

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In response to the article by E. Wellnhofer et al. (Int. J. Cardiovasc. Imaging 21,[575][576][577][578][579][580][581][582][583][584][585] In this issue of the International Journal of Cardiovascular Imaging, Wellnhofer et al.[1] report on the validation of angiographic right ventricular volume determination using magnetic resonance imaging as gold standard. Besides, there is another paper in this volume that is based on angiographic volume determination [2]. It describes right ventricular function after repair of tetralogy of Fallot using not only end-diastolic and end-systolic volumes but also the volume curve over a complete cardiac cycle.The angiographic determination of the ventricular volumes belongs to the oldest methods of quantitative image analysis. The basic techniques were developed 30 years ago, before digital imaging and multi-axial gantries were at our disposal in the catheterization laboratory. Other powerful image modalities were developed like echocardiography, cardiac magnetic resonance tomography and fast multi-slice computed tomography. The question arises whether it is still worthwhile to quantify right ventricular volumes from angiography. Are the results sufficient and accurate? And if the answers are yes, which method for angiographic right ventricular volume determination should be used in clinical routine? We will try to answer these questions based on the results of Wellnhofer et al.The assessment of the right ventricular volume and function is important for prognostic prediction and clinical decision making especially in paediatric cardiology. Although echocardiography has replaced angiocardiography for the diagnosis and follow-up of many patients, catheterization and the recording of angiograms are inevitable where local pressures and oxygen saturation should be measured or interventional procedures should be performed. Also the development of cardiac magnetic resonance tomography will not completely remove the more flexible and cost-efficient X-ray angiography. Especially for complex heart diseases and in paediatric cardiology the quantitative evaluation of the right ventricular size and function from angiograms are still of great importance.Using angiocardiography the ventricular volumes can be estimated from the opacified ventricular silhouettes only with the aid of model assumptions. There is no doubt that the variable and complex shape of the right ventricle cannot be approximated accurately from one projection alone. For the normal heart the combined use of the frontal and lateral views are well suited. However, for complex heart diseases other orthogonal projections may also be utilized. There are two approved techniques to calculate the volume from these projections: the area-length method and the multiple slices method. These techniques use the same information in a different order: either multiplication follows integration (of the silhouettes) or integration follows multiplication (of orthogonal diameters). In each case, the result has to be corrected to the true volume of ...

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Comparison of stroke work between repaired tetralogy of Fallot and normal right ventricular physiologies

et al. 2011

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Adult patients who underwent tetralogy of Fallot repair surgery (rTOF) confront life-threatening ailments due to right ventricular (RV) myocardial dysfunction. Pulmonary valve replacement (PVR) needs to be performed to restore the deteriorating RV function. Determination of correct timing to perform PVR in an rTOF patient remains subjective, due to the unavailability of quantifiable clinical diagnostic parameters. The objective of this study is to evaluate the possibility of using RV body surface area (BSA)-indexed stroke work (SW(I)) to quantify RV inefficiency in TOF patients. We hypothesized that RV SW(I) required to push blood to the lungs in rTOF patients is significantly higher than that of normal subjects. Seven patients with rTOF pathophysiology and eight controls with normal RV physiology were registered for this study. Right ventricular volume and pressure were measured using cardiac magnetic resonance imaging and catheterization, respectively. Statistical analysis was performed to quantify the difference in SW(I) between the RV of the rTOF and control groups. Right ventricular SW(I) in rTOF patients (0.176 ± 0.055 J/m(2)) was significantly higher by 93.4% (P = 0.0026) than that of controls (0.091 ± 0.030 J/m(2)). Further, rTOF patients were found to have significantly higher (P< 0.05) BSA normalized RV end-systolic volume, end-systolic pressure, and regurgitation fraction than control subjects. Ejection fraction and peak ejection rate of rTOF patients were significantly lower (P < 0.05) than those of controls. Patients with rTOF pathophysiology had significantly higher RV SW(I) compared with subjects with normal RV physiology. Therefore, RV SW(I) may be useful to quantify RV inefficiency in rTOF patients along with currently used clinical end points such as RV volume, pressure, regurgitation fraction, and ejection fraction.

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Angiocardiographic Pressure Volume Loops in the Analysis of Right Ventricular Function after Repair of Tetralogy of Fallot

Cited by 8 publications

References 12 publications

Energy Transfer Ratio as a Metric of Right Ventricular Efficiency in Repaired Congenital Heart Disease

Energy Transfer Ratio as a Metric of Right Ventricular Efficiency in Repaired Congenital Heart Disease

Angiographic Determination of Right Ventricular Volumes

Comparison of stroke work between repaired tetralogy of Fallot and normal right ventricular physiologies

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