Pulmonary annular excursión. Integral evaluation of the right ventricle with tetralogy of Fallot and pulmonary stenosis

Abstract

Objectives: surgery has improved the survival of patients with tetralogy of Fallot and pulmonary stenosis. Pulmonary regurgitation is the most frequent complication, requiring cardiac MRI to decide on reintervention. The objective was to evaluate the function of the right ventricular outflow tract through excursion of the pulmonary annulus by echocardiogram and its relationship with ejection fraction by MRI. Methods: patients were included who had repaired tetralogy of Fallot and pulmonary stenosis, with recent cardiac MRI (within the last year), and who had the following elements measured by Doppler echocardiogram: pulmonary annular plane systolic excursion, tricuspid annular plane systolic excursion, right ventricular S wave tissue Doppler velocity, and right ventricular fractional area change. They were compared with right ventricular ejection fraction. Results: Seventy patients were included, with tetralogy of Fallot in 65.7%. Pulmonary annular plane systolic excursion was greater in the group with preserved right ventricular ejection fraction: 10.8 vs 9.1 mm (p=0.021). Pulmonary annular plane systolic excursion showed a weak but statistically significant correlation coefficient with right ventricular ejection fraction (r 0.27 p < 0.05) and with tissue velocity S (r 0.31 p < 0 .01) but not with tricuspid annular plane systolic excursion. Conclusions: pulmonary annular plane systolic excursion is related to right ventricular ejection fraction and most indices of right ventricular systolic function.