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Correlation of right ventricular ejection fraction and tricuspid annular plane systolic excursion in tetralogy of Fallot by magnetic resonance imaging

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Abstract

The correlation between right ventricular ejection fraction (RVEF) and tricuspid annular plane systolic excursion (TAPSE) by two-dimensional (2-D) echo has been repeatedly validated, but not by magnetic resonance imaging (MRI) nor in patients with congenital heart disease. We tested whether TAPSE measurements by MRI correlate with RVEF in surgically repaired tetralogy of Fallot (TOF) patients. TAPSE was measured from systolic displacement of the RV-freewall/tricuspid annular plane junction in the apical 4-chamber view in 7 normal subjects and 14 TOF patients. The RV was reconstructed in 3-D from manually traced borders on MR images to compute true EF. Because we previously observed discrepancy between TAPSE and RVEF in the presence of regional dysfunction, we also analyzed RV wall motion in terms of regional stroke volume at 20 short axis slices from apex to tricuspid annulus. RVEF was 52 ± 3% in normal subjects and 41 ± 9% in TOF (P < 0.01). TAPSE correlated weakly (r = 0.50, P < 0.05) with RVEF. TOF patients exhibited increased regional stroke volume from apical portions of the RV and decreased regional stroke volume at the base compared to normal (P < 0.05 at 15 of 20 slices). Regional stroke volume in apical slices correlated inversely with RVEF such that patients with higher apical stroke volume had lower RVEF (P < 0.05). TAPSE is not a reliable measure of RVEF in TOF by MRI. TAPSE may be of limited use in conditions that exhibit abnormal regional contraction.

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Acknowledgments

Supported in part by grants from the John L. Locke, Jr. Charitable Trust and VentriPoint, Inc. (both of Seattle, WA).

Conflict of interest disclosures

Dr. Sheehan is a founder and equity holder in VentriPoint, Inc. The remaining authors have no disclosures of conflict of interest.

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Authors and Affiliations

  1. The Cardiovascular Research and Training Center, University of Washington, Box 356422, Seattle, WA, 98195-6422, USA

    Peter Morcos & Florence H. Sheehan

  2. Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA

    G. Wesley Vick III

  3. Pediatric Cardiology, Oregon Health & Science University, Portland, OR, USA

    David J. Sahn

  4. Cardiovascular Imaging Section, Brigham & Women’s Hospital, Boston, MA, USA

    Michael Jerosch-Herold

  5. North Cascade Cardiology, Bellingham, WA, USA

    Alan Shurman

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  1. Peter Morcos
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  2. G. Wesley Vick III
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  4. Michael Jerosch-Herold
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  6. Florence H. Sheehan
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Correspondence to Florence H. Sheehan.

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Morcos, P., Vick, G.W., Sahn, D.J. et al. Correlation of right ventricular ejection fraction and tricuspid annular plane systolic excursion in tetralogy of Fallot by magnetic resonance imaging. Int J Cardiovasc Imaging 25, 263–270 (2009). https://doi.org/10.1007/s10554-008-9387-0

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  • DOI: https://doi.org/10.1007/s10554-008-9387-0

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