Best Parameter for the Evaluation of Right Ventricular Function by 2D Echocardiography in Patients With Corrected Tetralogy of Fallot

Echocardiography has a widespread role in measuring cardiac function and hemodynamics. Nevertheless, the evaluation of right ventricular (RV) function is a puzzle, especially by 2D echocardiography, because of the complex anatomy of this chamber. Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart disease, and an accurate evaluation of RV function is important for planning the time for pulmonary valve surgery after initial correcting surgery. Although cardiovascular magnetic resonance imaging (CMR) is the gold standard tool for measuring the right ventricular ejection fraction (RVEF), we sought to determine which classic factor for the evaluation of RV function by 2D echocardiography matched relevant CMR findings the most.

All patients (N = 26) with corrected ToF referred for CMR in Rajaie Cardiovascular Medical and Research Center between June 2018 and January 2019 were evaluated by 2D echocardiography. The findings relating to RV function by the 2 methods were analyzed using the SPSS software, version 22.

Of the 4 classic parameters for the evaluation of RV function by 2D echocardiography, only fractional area change had a statistically significant correlation with RVEF by CMR (AUC for the evaluation of RVEF ≥ 45%: 0.813, P = 0.012; the Spearman correlation coefficient: 0.40, P = 0.04). Additionally, tricuspid annular plane systolic excursion, S’, and the RV index of myocardial performance could not predict RVEF in our patients with corrected ToF.

Fractional area change is a suitable parameter for the evaluation of RVEF in patients with ToF; nonetheless, the other classic parameters of RV function in 2D echocardiography cannot predict RV function in these patients. (Iranian Heart Journal 2020; 21(3): 40-47)