Echocardiographic Parameters of Right Ventricular Diastolic Function in Repaired Tetralogy of Fallot Are Associated with Important Findings on Magnetic Resonance Imaging

Abstract

Echocardiographic parameters of diastolic dysfunction have a reasonable PPV but poor NPV for predicting clinically significant risk factors identified by CMR.

The Role of Echocardiography in Neonates and Pediatric Patients on Extracorporeal Membrane Oxygenation

“…The assessment of RV diastolic function should be included in the routine pre-ECMO echocardiogram, as diastolic dysfunction can precede declines in systolic function and appears to correlate with risk factors such as RV dilatation ( 67 , 68 ). Pulsed wave Doppler measurement of tricuspid inflow and myocardial DTI is one method of diastolic analysis that yields objective data for E/A and E/e' ratios.…”

How best to assess right ventricular function by echocardiography

“…64 In tetralogy of Fallot, measures of diastolic dysfunction appear to correlate with risk factors for future re-interventions, such as greater degree of right ventricular dilatation. 65 The assessment of right ventricular diastolic function is obtained by Doppler interrogation of the tricuspid inflow, tissue Doppler interrogation of the lateral tricuspid valve annulus, Doppler interrogation of the hepatic veins, assessment of the right atrium, as well as assessment of the size and collapsibility of the inferior caval vein. Owing to the different phases of diastole, the evaluation of diastolic function should include multiple parameters.…”

Altered Aortic Upper Wall TDI Velocity Is Inversely Related with Left Ventricular Diastolic Function in Operated Tetralogy of Fallot

“…However, the relationship between aortic elastic properties and diastolic function in TOF patients is confirmed even when excluding patients who had undergone previous palliative surgery; (8) the fact that cardiac catheterization—aimed at evaluating intraventricular pressures—was not performed at the time of the study, particularly as dp/dt may affect aortic wall TDI measurements; (9) similarly, other factors that may potentially have contributed to the reduction in arterial elasticity in TOF should be taken into account (i.e., progression of vascular calcifications, brain natriuretic peptide levels, angiotensin serum levels, repeated episodes of acute hypoxia, long operative procedures, bi‐ventricular diastolic interaction). Regarding the latter, it has been demonstrated that right ventricular filling may affect LV filling pressures through the presence of end‐diastolic forward flow in the main pulmonary artery, more pronounced pulmonary venous return, and larger left atrial size); (10) finally, cardiac magnetic resonance imaging (MRI) is routinely performed at follow‐up in numerous congenital heart diseases, including TOF, as it yields higher definition imaging of both aortic diameters and elastic properties compared to echographic techniques . Based on these premises, the authors intend to replicate the present study using MRI in the near future.…”