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01-04-2021 | Magnetic Resonance Imaging | Original Article

Ventriculotomy Decreases Agreement Between Assessment of Right Ventricular Function by Echocardiography and Cardiac Magnetic Resonance Imaging in Patients with Hypoplastic Left Heart Syndrome

Authors: Alan P. Wang, Angela M. Kelle, Meredith Hyun, Chelsea L. Reece, Phillip M. Young, Patrick W. O’Leary, M. Yasir Qureshi, Wanek Family Program for Hypoplastic Left Heart Syndrome Imaging Pipeline

Published in: Pediatric Cardiology | Issue 4/2021

Abstract

Accurate assessment of the right ventricular (RV) volume and function is important in patients with hypoplastic left heart syndrome (HLHS). We sought to investigate the effect of ventriculotomy on the correlation of RV functional assessments by two-dimensional echocardiography (2DE) to cardiac magnetic resonance (CMR)-derived RV ejection fraction (EF) in patients with HLHS. A retrospective re-analysis of CMR imaging with matched 2DE was performed from the institutional HLHS registry. Echocardiographic RV functional parameters were analyzed and correlated with CMR-derived EF. Intraclass correlation coefficient was used to determine interobserver reliability. A total of 58 matched echocardiograms and CMR imaging studies from 46 patients was evaluated. Median duration between CMR imaging and echocardiogram was 1 day (range 0–6 days). No significant difference was seen in CMR RV EF between patients with and without a ventriculotomy (EF − 43.6% vs 44.7%, p = 0.85). The presence of a ventriculotomy significantly decreased the correlation of biplane FAC (r = 0.86 vs 0.52; p = 0.02), triplane FAC (r = 0.84 vs 0.49; p = 0.03), and 2DE visually estimated EF (r = 0.83 vs 0.49; p = 0.02). The correlation of circumferential and longitudinal strains to CMR-derived EF was not significantly affected by the presence of a ventriculotomy. A prior ventriculotomy significantly affected correlation between 2DE FAC and visually estimated EF with CMR-derived EF. The dyskinetic myocardial segment due to ventriculotomy, which is often not visualized by 2DE, may be the reason for this discrepancy.

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Title: Ventriculotomy Decreases Agreement Between Assessment of Right Ventricular Function by Echocardiography and Cardiac Magnetic Resonance Imaging in Patients with Hypoplastic Left Heart Syndrome
Authors: Alan P. Wang
Angela M. Kelle
Meredith Hyun
Chelsea L. Reece
Phillip M. Young
Patrick W. O’Leary
M. Yasir Qureshi
Wanek Family Program for Hypoplastic Left Heart Syndrome Imaging Pipeline
Publication date: 01-04-2021
Publisher: Springer US
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Echocardiography
Echocardiography
Published in: Pediatric Cardiology / Issue 4/2021
Print ISSN: 0172-0643
Electronic ISSN: 1432-1971
DOI: https://doi.org/10.1007/s00246-021-02569-2

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