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Tricuspid annular plane systolic excursion and right ventricular ejection fraction in pediatric and adolescent patients with tetralogy of Fallot, patients with atrial septal defect, and age-matched normal subjects

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Abstract

Aims

To determine whether TAPSE is an accurate marker of right ventricular (RV) systolic function in patients with tetralogy of Fallot (TOF) and patients with small atrial septal defect (ASD). The tricuspid annular plane systolic excursion (TAPSE) values were measured and compared with RV ejection fraction (EF).

Methods and results

A prospective study was conducted in pediatric and adolescent patients with TOF (n = 110), with isolated small secundum ASD (n = 200), and age-matched patients with normally structured heart. The TAPSE values showed a positive correlation with age in both patients with ASD and normal subjects. No significant difference of TAPSE values was seen in control subjects and age-matched ASD patients. The TAPSE was not decreased compared to normal subjects in eight infant TOF patients before corrective surgery. A reduction of TAPSE values with increasing time interval following corrective surgery was seen. After a mean of 7 years TAPSE values become significantly reduced compared to age-matched controls, being below the lower bound of the −2 SD.

Conclusion

In ASD patients the systolic RV function was preserved over the pediatric age group when compared to normal subjects. In contrast, although initially preserved, we found an impaired TAPSE with increasing postoperative period in our TOF patients.

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Abbreviations

ASD:

Atrial septal defect

BSA:

Body surface area

EF:

Ejection fraction

LV:

Left ventricle

EDV:

End-diastolic volume

TOF:

Tetralogy of Fallot

SD:

Standard deviation

PR:

Pulmonary regurgitation

PA:

Pulmonary artery

RV:

Right ventricle

MRI:

Magnetic resonance imaging

NYHA:

New York Heart Association

TAP:

Transannular patch

TAPSE:

Tricuspid annular plane systolic excursion

TR:

Tricuspid regurgitation

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Acknowledgments

There are no financial relationships relevant to this article to disclose.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Auenbruggerplatz 30, 8036, Graz, Austria

    Martin Koestenberger, Bert Nagel, Bernd Heinzl & Andreas Gamillscheg

  2. Division of Pediatric Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    William Ravekes & Allen D. Everett

  3. Data, Statistics and Risk Assessment, Austrian Agency for Health and Food Safety, Graz, Austria

    Hans Peter Stueger

  4. Division of Pediatric Radiology, Department of Radiology, Medical University Graz, Graz, Austria

    Erich Sorantin

  5. Institute of Physiological Chemistry, Centre of Physiological Medicine, Medical University Graz, Graz, Austria

    Gerhard Cvirn

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  1. Martin Koestenberger
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Correspondence to Martin Koestenberger.

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Koestenberger, M., Nagel, B., Ravekes, W. et al. Tricuspid annular plane systolic excursion and right ventricular ejection fraction in pediatric and adolescent patients with tetralogy of Fallot, patients with atrial septal defect, and age-matched normal subjects. Clin Res Cardiol 100, 67–75 (2011). https://doi.org/10.1007/s00392-010-0213-z

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  • DOI: https://doi.org/10.1007/s00392-010-0213-z

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