Assessment of right ventricular function in children with congenital heart disease Doppler tissue imaging

OBJECTIVE: To assess right ventricular dysfunction in children with congenital heart disease (CHD) by measurement of tricuspid annular diastolic velocity Aa/Ea ratio by doppler tissue imaging (DTI).

METHODS: A case-control study was performed on 141 children with CHD who were referred to Aliasghar Hospital of Zahedan, Iran for cardiac catheterization from April 2004 to December 2005. Tricuspid inflow velocity (A/E ratio) and Aa/Ea ratio was measured by DTI. Patients were catheterized afterwards. Cumulative data were analyzed by Statistical Package for Social Sciences and evaluated using t-test and correlation.

RESULTS: There was significant correlation between Aa/Ea ratio by DTI, and hemodynamic criteria derived at catheterization. It was also diagnosed that 77 patients of 141 had right ventricular dysfunction by DTI, whereas 74 of them showed this problem at catheterization. The sensitivity of this method for evaluation of right ventricular dysfunction was 95%, and specificity was 98%. The positive predictive value 95%, and negative predictive value 98% were assessed.

CONCLUSION: Finding of this study showed that we can use DTI for diagnosis of right ventricular dysfunction in children with CHD, and it can be used instead of catheterization especially in unstable patients.