Ventricular Functions in Congenital Heart Diseases: A Tissue Doppler Study

Abstract

Background: Congenital heart diseases (CHD) account for one third of all congenital anomalies. Doppler and Tissue Doppler evaluate cardiac performance and diagnose CHD. Study aim: evaluation ventricular functions in congenital heart diseases using tricuspid plane systolic excursion TAPSI and tissue Doppler-derived left ventricular myocardial performance index MPI.

Methods: The study was performed at Pediatric Cardiology Unit of Zagazig University Hospitals on 70 age and sex matched children classified into case group  included 35 patients with CHD and control group included 35 healthy children underwent complete history, conventional echocardiographic and tissue Doppler examination.

Results: There was increase in cases regarding interventricular septum (IVS) and  decrease in left ventricular diameter at end diastole (LVDd), left ventricular diameter at end systole (LVDs), right pulmonary artery  diameter (RPA) and left atrium diameter more than control group with no difference in between regarding: posterior wall diameter (PW),  fractional shortening (FS), main pulmonary artery diameter, left pulmonary artery diameter (LPA) and aorta diameter. There was a highly  significant decrease in TAPSE in case more than control group and significant decrease in ejection time (ET) with no significant difference  between case and control group regarding LV MPI.

Conclusions: TAPSE is lower in cases compared with control group indicating  longitudinal RV dysfunction. The value of LV MPI was slightly higher than that of control that need further studies with a larger number of  patients.LV FS did not show any abnormality in cases pointing out ability of tissue Doppler echocardiography to measure segmental LV  dysfunction compared to conventional echocardiography.