title: Doppler-derived strain and strain rate imaging assessment of right ventricular systolic function in adults late after tetralogy of Fallot repair: an observational study.
abstract: OBJECTIVE
  Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. Today, we are faced with an increasing number of patients with residual pulmonary regurgitation (PR) late after TOF repair. The right ventricular (RV) volumes and function are among the most important factors influencing clinical decision-making. Cardiac magnetic resonance (CMR) is the gold standard method for the quantitative assessment of the RV function; it is, however, expensive for routine clinical follow-up and sometimes is contraindicated. We sought to evaluate the RV systolic function via CMR and compare it with Doppler-derived strain(S) and strain rate (SR) imaging in patients with repaired TOF.
  
  
  METHODS
  In an observational cross-sectional study, 70 patients (22 women, mean age=22±4.9 years) late after TOF repair with severe PR were evaluated. Peak systolic strain and SR in the basal, mid, and apical segments of RV free wall (RVFW) were measured and compared with the RV function measured in the short-axis cine MR. Associations between RVEF and S/SR, investigated by ordinal logistic regression models.
  
  
  RESULTS
  Significant association was observed between RV function and mean S of all the three segments of the RVFW segments [OR (CI95%): 1.17 (1.05-1.31)]. Association between RV function and mean SR of all the three segments of the RVFW segments was borderline significant [OR (CI95%): 1.7 (0.97-2.93)].
  
  
  CONCLUSIONS
  There was a significant correlation between the Doppler-derived mean strain of RVFW and the RV function measured by CMR in adults late after TOF repair. These quantitative methods improved the assessment of the RV function and served as an additional method to follow up patients with contraindications to CMR.
authors.affiliation: Echocardiography Laboratory, Cardiac Imaging and Echocardiography Research Center, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Echocardiography Research Center, Tehran-Iran. ani_echocard@yahoo.com.
authors.forename: Anita
authors.initials: A
authors.lastname: Sadeghpour
authors.forename: Majid
authors.initials: M
authors.lastname: Kyavar
authors.forename: Shabnam
authors.initials: S
authors.lastname: Madadi
authors.forename: Leili
authors.initials: L
authors.lastname: Ebrahimi
authors.forename: Zahra
authors.initials: Z
authors.lastname: Khajali
authors.forename: Zahra Alizadeh
authors.initials: ZA
authors.lastname: Sani
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000473:pathology; D011665:Pulmonary Valve Insufficiency / Q000000981:diagnostic imaging* / Q000473:pathology; D013771:Tetralogy of Fallot / Q000601:surgery*; D014421:Turkey; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging*