Echocardiographic right ventricle longitudinal contraction indices cannot predict ejection fraction in post-operative Fallot children.

International audienceAIMS: To examine in a population of post-operative tetralogy of Fallot patients, the correlation between right ventricle (RV) ejection fractions (EF) computed from magnetic resonance imaging (MRI) and three echocardiographic indices of RV function: TAPSE, longitudinal strain and strain rate. Indeed, these patients present a pulmonary regurgitation which is responsible for progressive dilatation of the RV. An echocardiographic assessment of the RV function would be very useful in determining the timing of pulmonary revalvulation for Fallot patients. However, these indices are generally based on the ventricle contraction in the long axis direction which is impaired in this population and does not seem to correlate with the EF. METHODS AND RESULTS: Thirty-five post-operative tetralogy of Fallot patients and 20 patients with normal RVs were included. In both groups, RVEF, assessed by MRI, was compared with the three echocardiographic indices. Longitudinal strain and strain rates were computed both on the free wall and on the whole RV. No correlation was found between the echocardiographic indices and the MRI EF in our Fallot population. The accuracy of those indices as a diagnostic test of an altered RV was low with Younden's indices varying from -0.18 to 0.5 and areas under the Receiver Operating Characterictic (ROC) curves equal to 0.54 for tricuspid annulus plane systolic excursion, 0.59-0.62 for strain and 0.57-0.63 for strain rate. CONCLUSION: Three conventional echocardiographic indices based on RV longitudinal contraction failed to assess the EF in our population of post-operative tetralogy of Fallot patients

0304: Impact of global and segmental hypertrophy on 3D systolic deformation in hypertrophic cardiomyopathy: comparison with healthy subjects

ObjectivesTo study the impact of hypertrophy on global and regional 3D systolic deformation in primary hypertrophic cardiomyopathy (HCM) as compared with controls.MethodsA comprehensive resting 2D and 3D echocardiography was performed in 40 HCM and in 107 controls comparable regarding age, gender and left ventricular ejection fraction (LVEF). LV global (G) and segmental (S) measurements of all 3D peak strain components (longitudinal: 3DGLS, 3DSLS, circumferential: 3DGCS, 3DSCS, radial: 3DGRS, 3DSRS and area: 3DGAS, 3DSAS) and 3D indexed LV end-diastolic myocardial mass (3D indexed LVED mass) were obtained from all patients. LV wall thickness (LVWT) of the 16 LV segments was assessed in short-axis views and classified in 4 quartiles (< 10.5mm, 10.5-13.0mm, 13.0-16.5mm and >16.5mm).ResultsGlobal deformation parameters were all decreased in HCM patients as compared to controls, except for 3DGCS. There was a significant correlation between indexed 3D LVED mass and all strains components (3DGLS: r2=0.50; 3DGAS: r2=0.50; 3DGRS: r2=00.47; 3DGCS: r2=0.40; p<0.05 for all). For segmental deformation, the absolute value of all types of strain decreased from 2nd to 4th quartile of myocardial thickness (p<0.05). As compared to controls, 3DSLS and 3DSAS were decreased for all quartiles (p<0.05), 3DSRS was lower from 2nd to 4th quartile (p<0.05) and 3DSCS was higher in 1st and 2nd quartile (p<0.05, Figure 1 next page).ConclusionMyocardial mass is related with all 3D strain components in HCM patients. Segmental longitudinal deformation is decreased whatever the degree of LVWT, whereas 3D circumferential strain absolute value is increased in none and poorly hypertrophied segments compared to controls suggesting that it may play a key role of in the preservation of the systolic function in HCM patients.Abstract 0304 - Figure