Assessment of Longitudinal Systolic Ventricular Dysfunction and Asynchrony Using Velocity Vector Imaging in Children With a Single Right Ventricle

Abstract

Assessment of ventricular dysfunction and asynchrony is very important in predicting the outcome for children with a single right ventricle. However, the assessment is inaccurate and subjective because of the unusual ventricular shape. This study aimed to evaluate the feasibility and clinical value of velocity vector imaging for assessing longitudinal systolic ventricular dysfunction and intraventricular asynchrony in children with a single right ventricle. The study enrolled 36 children with a single right ventricle and 36 age-matched children with a normal heart. Peak systolic velocity, peak displacement, strain, strain rate, time to peak systolic velocity, and time to peak systolic strain were measured via velocity vector imaging using the Siemens Sequoia C512 echocardiography instrument. The maximum positive rate of ventricular pressure change (Max [dp/dt]) was obtained by cardiac catheterization for all the children with a single right ventricle. In the children with a single right ventricle, the maximal temporal differences and the standard deviations of the times to peak systolic velocity and peak systolic strain were higher (P < 0.01) than in the children with a normal heart. Moreover, the strain and strain rate values were significantly lower in all six segments (P < 0.05). The strain rate of the basal segment adjacent to the rudimentary chamber correlated best with Max (dp/dt) (r = 0.86; P < 0.01). Longitudinal systolic dysfunction and intraventricular asynchrony could be assessed accurately using velocity vector imaging in children with a single right ventricle.

Longitudinal Myocardial Deformation Does Not Predict Single Ventricle Ejection Fraction Assessed by Cardiac Magnetic Resonance Imaging in Children with a Total Cavopulmonary Connection

“…However, Kaneko et al [ 17 ] found in a small study (20 children with TCPC, mean age 3.4 years) that global peak longitudinal strain was − 16.6% in children with RV morphology versus − 20.5% in children with LV morphology ( p = 0.01). Studies performed in TCPC patients with only one type of single ventricle morphology report global longitudinal strain values in RV morphology ranging from − 12.0 to − 18.9% [ 7 , 18 – 21 ] and in LV morphology ranging from − 14.2 to − 18.3% [ 18 , 22 , 23 ]. However, these studies are difficult to compare, since they vary in important factors, including age of study participants, time after completion of the TCPC, type of surgical procedure, type of echocardiographic equipment used, and underlying specific single ventricle morphology.…”

“…The major strengths of this study are the relatively large number of TCPC patients included and the ability to compare a number of potentially relevant functional parameters, including extensive echocardiographic data (both conventional and innovative parameters such as strain and SR) as well as cMRI data. Other studies using myocardial deformation in single ventricle patients with a TCPC often included rather small numbers of patients [ 7 , 8 , 17 – 19 , 21 – 23 , 28 ] which might result in lack of statistical power.…”

Feasibility of Computational Fluid Dynamics for Evaluating the Intraventricular Hemodynamics in Single Right Ventricle Based on Echocardiographic Images

“…The SRV has the right ventricle anatomy but works as both pulmonic and systemic circulation ventricles; it is usually unable to sustain separate pulmonary and systemic circulations in sequence, nevertheless offering normal ventricular performance. The SRV has impaired systolic and diastolic function compared with that of the respective ventricles in a normal biventricular heart [ 1 ].…”

Study of Regional Left Ventricular Longitudinal Function in Fetuses with Gestational Diabetes Mellitus by Velocity Vector Imaging

“…A recently developed new technique—velocity vector imaging (VVI), based on two‐dimensional images—utilizes ultrasonic speckle tracking to derive directionally unconstrained imaging of myocardial motion, which can be used to estimate regional and global myocardium function. Tissue velocity, S, and SR data had been published for a group of normal fetuses . No studies of fetuses with GDM by VVI have been reported.…”

“…Tissue velocity, S, and SR data had been published for a group of normal fetuses. 7,8 No studies of fetuses with GDM by VVI have been reported.…”