Myocardial acceleration during isovolumic contraction as a new index of right ventricular contractile function and its relation to pulmonary regurgitation in patients after repair of tetralogy of Fallot.
BACKGROUND
Myocardial acceleration during isovolumic contraction (IVA) by Doppler tissue imaging has been proposed to be a new index of right ventricular contractile function that is unaffected by ventricular shape or loading conditions.


OBJECTIVE
We sought to assess the use of IVA to evaluate right ventricular contractile function.


METHODS
In all, 22 pediatric patients with pulmonary regurgitation (PR) after repair of tetralogy of Fallot (TOF) (8 +/- 3 years) and 27 age-matched children were examined. The degree of PR (mild, moderate, and severe) for patients with TOF was on the basis of pulsed and color Doppler findings. Using Doppler tissue imaging, the peak myocardial velocities during early diastole, late diastole, systole, and isovolumic contraction were recorded.


RESULTS
Compared with healthy children, Doppler tissue imaging velocities for patients with TOF showed decreased myocardial velocities during early diastole (P =.007), late diastole (P <.0001), systole (P <.0001), and isovolumic contraction (P <.0001). Patients with TOF had a lower IVA when compared with healthy children (P <.0001). There was a stepwise decrease in the IVA from mild to severe PR. We found a significant relationship between the IVA and the degree of PR (r = -0.86, P <.0001).


CONCLUSIONS
The analysis of IVA allows the assessment of right ventricular contractile function for patients with repaired TOF and various degrees of PR.
Toyono
Manatomo
M
Department of Pediatrics, Akita University School of Medicine, Japan.
Harada
Kenji
K
Tamura
Masamichi
M
Yamamoto
Fumio
F
Takada
Goro
G
D000054:Acceleration; D001783:Blood Flow Velocity / Q000502:physiology; D006348:Cardiac Surgical Procedures; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D003326:Coronary Circulation / Q000502:physiology; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D006801:Humans; D009200:Myocardial Contraction / Q000502:physiology*; D015588:Observer Variation; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D011665:Pulmonary Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013771:Tetralogy of Fallot / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome; D016278:Ventricular Function, Right / Q000502:physiology*