Vol. 45 | No. 1 | January-June 2017 Back

Open Access

Correlation of RV Strain Imaging Parameters with Cardiac MRI Parameters in the Assessment of RV Function Among Repaired Tetralogy of Fallot Patients

Lorielyn G. Mandigma
Jun 2017 DOI 10.69944/pjc.1592f7710d

Abstract

Background: Strain imaging offers an alternative non-invasive method to quantify right ventricular (RV) function.  This study aims to utilize strain imaging in the assessment of RV function among repaired tetralogy  of Fallot patients in order to determine clinical RV dysfunction. 

Methodology: This is a prospective cross-sectional study done at the Philippine Heart Center. Cardiac magnetic  resonance imaging (CMR) and echocardiographic strain imaging were done on the same day for  each study participant. Statistical comparison was performed. Sensitivity and specificity curves (using  CMR-derived RV ejection fraction [RVEF] as the reference test) was used to determine optimal cut off values for global and regional longitudinal systolic strain and strain rate. Intra-observer variability  was also determined.  

Results: Twenty-two participants were included. There was significant inverse moderate correlation between  CMR-derived RVEF and RV free wall (RVFW) mid-segment strain (r=–0.42; p=0.05) and global  longitudinal strain (r= 0.62; p=0.002). The determined cut-off for RV dysfunction for RV global  longitudinal strain was –20.66%, which showed a sensitivity of 88.83%, specificity of 100%, positive  predictive value (PPV) of 100% and negative predictive value (NPV) of 88.83%. RVFW mid-segment  strain determined cut-off was –16.25, which showed a sensitivity of 83.33%, specificity of 100%,  PPV of 100% and NPV of 83.33%. 

Conclusion: Strain imaging is an easy, feasible and reproducible parameter in two-dimensional echocardiography  that can be a good screening tool, with high sensitivity and specificity for detecting RV dysfunction  among patients with repaired tetralogy of Fallot. 

Keywords: tetralogy of Fallot, right ventricular dysfunction, strain imaging.

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