Right ventricular long axis function in adults and children with Ebstein's malformation.
OBJECTIVE
To assess right ventricular function in adults and children with Ebstein's anomaly.


METHODS
Prospective study.


METHODS
Tertiary referral centre.


METHODS
Fifteen patients (8 adults and 7 children) with Ebstein's anomaly and 14 healthy controls.


METHODS
Transthoracic echocardiography was performed in all. Right ventricular function was assessed from long axis M-mode recordings of the right atrio-ventricular free wall. Total systolic excursion as well as peak shortening and lenghtening rates of the right ventricle were measured.


RESULTS
Children and adult patients with Ebstein's anomaly differed in terms of age at diagnosis, the adult group having been diagnosed later 19.8+/-15.8 vs. 5.9+/-6.2 years, P<0.05. Measures of right ventricular long axis function in children with Ebstein's anomaly showed a significantly reduced systolic excursion 1.4+/-0.4 vs. 2.4+/-0.53 cm, P<0.05 and peak lenghtening rate; early 8.04+/-4.3 vs. 11.8+/-2.4 cm/s and late 6.14+/-3.6 vs. 10.6+/-4.3 cm/s, P=0.05 compared to controls. In contrast, measurements of right ventricular long axis function in adults with Ebstein's anomaly showed no significant difference when compared to the control group. Transtricuspid Doppler flow velocities were not different between patient's groups and corresponding controls.


CONCLUSIONS
The right ventricle assessed by this simple, non-invasive technique reveals a significantly reduced systolic and diastolic function in children with Ebstein's malformation compared to controls but a 'normal' right ventricular function comparable to controls in adult patients. Significant right ventricular dysfunction in children with Ebstein's anomaly could account for their earlier presentation. Long term follow up of the right ventricular abnormalities is needed in such children to discover more about the natural history of the disease.
Therrien
J
J
Cardiac Department, Royal Brompton and Harefield Trust and National Heart and Lung Institute, Imperial College, London, UK.
Henein
M Y
MY
Li
W
W
Somerville
J
J
Rigby
M
M
D000328:Adult; D002648:Child; D002675:Child, Preschool; D004437:Ebstein Anomaly / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography; D016278:Ventricular Function, Right