Velocity vector imaging for the assessment of segmental ventricular function in children with a single right ventricle after cavopulmonary anastomosis

Abstract

Objective: Ventricular function assessment is very important for the treatment and prognostic classification of children with a single right ventricle (SRV) after cavopulmonary anastomosis (CPA). However, unusual ventricular shapes can result in inaccurate measurements. The aim of this study was to evaluate velocity vector imaging (VVI) for assessing segmental ventricular function in children with SRV after CPA.

Methods: Twenty-one children with SRV after CPA and 21 age- and sex-matched children with normal biventricular anatomy and function were included. The longitudinal velocity, displacement, strain and strain rate were measured in the two groups in six segments by VVI. The velocity, displacement, strain and strain rate of the SRVs were compared with max(dp/dt) measured during simultaneous cardiac catheterization in the SRV subjects.

Results: The control group consisted of 13 males and 8 females (69% males) with a mean age of 6.7 ± 3.5 years and mean weight of 20.5 ± 6.5 kg, and the study group consisted of 13 males and 8 females with a mean age 6.7 ± 3.7 years and mean weight of 20.6 ± 6.8 kg. Age, weight and sex distribution were similar between the groups (all, p > .05). Strain and strain rate values in all six segments were significantly lower in the study group than in the control group (all, p < .05). The max(dp/dt) of the SRV was 522.84 ± 158.32 mmHg/s, and the strain rate of the basal segment at the rudimentary chamber correlated best with max(dp/dt) (r = 0.74, p < .01).

Conclusions: Segmental ventricular dysfunction was present in children with SRV after CPA, and it could be assessed using VVI.

Keywords:

• Congenital heart disease
• right ventricle
• ventricular function
• strain
• strain rate

Transparency

Declaration of funding

This work was supported by programs from the Programs of the Shanghai Science and Technology Commission (grant number 14411961700), and the clinical science and technology innovation project of the Shanghai Shen Kang Hospital Development Center (grant number SHDC22015019).

Author contributions: L.J.C. conceptualized and designed the study, drafted the initial manuscript and approved the final manuscript. S.F.B. and S.W.Z. carried out the initial analyses. Y.Q.Z. reviewed and revised the manuscript, and approved the final manuscript. A.M.S. and Z.F.Z. designed the data collection instruments, and coordinated and supervised data collection.

Declaration of financial/other relationships

L.J.C., Y.Q.Z., S.F.B., S.W.Z., A.M.S. and Z.F.Z. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

None reported.