EFFECT OF PULMONARY HYPERTENSION SECONDARY TO CONGENITAL HEART DISEASE ON RIGHT VENTRICULAR VOLUMES AND FUNCTION: A COMPARATIVE STUDY BETWEEN TWO DIMENSIONAL, THREE DIMENSIONAL ECHOCARDIOGRAMS AND INVASIVE RV QUANTIFICATION

Esmail, Yasmin A.; EL Shahid, Ghada S.; Roushdy, Alaa M.; Hussein, Mohamed R.

doi:10.21608/asmj.2019.111188

EFFECT OF PULMONARY HYPERTENSION SECONDARY TO CONGENITAL HEART DISEASE ON RIGHT VENTRICULAR VOLUMES AND FUNCTION: A COMPARATIVE STUDY BETWEEN TWO DIMENSIONAL, THREE DIMENSIONAL ECHOCARDIOGRAMS AND INVASIVE RV QUANTIFICATION

Document Type : Original Article

Authors

Department of Cardiology, Faculty of Medicine, Ain Shams University.

10.21608/asmj.2019.111188

Abstract

Background: Quantitative echo cardiographic assessment of right ventricular (RV) function is becoming of increasing interest in cardiac diseases that affect the right ventricle, such as congenital heart disease and acute or chronic pulmonary hypertension (PH),but is still challenging due to RV complex anatomy and structure. Aim of the Work: To study the effect of PH on the RV volumes and function using 2DE, 3DE and RV quantification by angiography in patients with PH secondary to congenital heart disease and to compare between 3D RV quantification by echocardiogram and invasive by
angiography in patients with PH secondary to congenital heart disease. Patients and Methods: This cross sectional study included all patients with congenital heart diseases complicated by pulmonary hypertension referred to cardiology department in Ain shams university hospital for elective hemodynamic assessment. Results: The diagnostic accuracy of 3D RV and angiography (Ang.) RV parameters for detecting hemodynamic signs of pulmonary hypertension (a composite of PVR > 7) was shown by receiv‐er operating characteristic curves. The parameters with the largest areas under the
curve (AUC) were: 3D tenting volume (1.000) had the highest area under the curve followed by mean PAP and PASP, followed by 3D ‐ TV annulus area, Ang. RV EF,3D RV EF And lastly FAC. The best cut-off values of: 3D TV tenting volume >4.8 (Se: 100%, Sp: 100%), PASP >80(Se: 100%, Sp: 97.5%), mean PAP >50 (SE:100, SP: 97.5%), 3D TV annulus area >9.3 (SE: 100%, SP: 92.5), Ang. RV EF < =36% (SE=100%, SP= 80%), 3D RV EF <=42% (SE=100%, SP+77.5%)and RV FAC<=36 % (Se:100%, Sp: 67.5%). Conclusion: In PH patients, the quantitative assessment of global
and regional RV function by 3D provided a useful hemodynamic and prognostic information. Several indices can be obtained by 3D echocardiography non-invasively, to predict the PVR in congenital heart disease with PH.

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