Table 3.
2D echocardiographic-Doppler indices of RV systolic, diastolic and global function at three post-operative intervals by shunt type
Variable | Post-Norwood | Pre-stage II | 14 months | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N | MBTS | N | RVPAS | p | N | MBTS | N | RVPAS | p | N | MBTS | N | RVPAS | p | |
RV systolic function | |||||||||||||||
RV ejection fraction % (biplane pyramidal) | 169 | 44±8 | 198 | 49±7 | <0.001 | 127 | 43±8 | 153 | 45±9 | 0.12 | 104 | 43±7 | 132 | 43±8 | 0.91 |
RV % area change | 224 | 35±8 | 236 | 38±7 | <0.001 | 167 | 33±7 | 208 | 34±8 | 0.45 | 134 | 33±7 | 170 | 32±7 | 0.49 |
RV dP/dt, mmHg/sec | 46 | 1032±330 | 41 | 983±336 | 0.50 | 35 | 865±301 | 47 | 871±335 | 0.93 | 24 | 798±318 | 28 | 854±402 | 0.59 |
Tricuspid annular tissue Doppler peak systolic velocity, cm/sec | 205 | 4.51±1.36 | 213 | 4.40±1.11 | 0.38 | 153 | 5.80±1.98 | 188 | 5.22±1.43 | 0.003 | 140 | 5.46±1.49 | 171 | 5.29±1.37 | 0.28 |
Tricuspid annular tissue Doppler isovolumic acceleration, cm/sec/sec | 41 | 26.6±12.8 | 29 | 26.7±10.9 | 0.97 | 57 | 31.8±11.3 | 69 | 31.3±12.7 | 0.80 | 71 | 35.2±11.7 | 95 | 35.1±11.2 | 0.95 |
RV diastolic function | |||||||||||||||
Peak tricuspid inflow E velocity, m/sec | 217 | 0.83±0.26 | 224 | 0.79±0.23 | 0.09 | 160 | 0.86±0.26 | 199 | 0.86±0.25 | 0.87 | 141 | 0.86±0.25 | 179 | 0.86±0.25 | 0.91 |
Peak tricuspid inflow A velocity, m/sec | 91 | 0.66±0.21 | 108 | 0.66±0.19 | 0.90 | 94 | 0.80±0.21 | 107 | 0.74±0.21 | 0.07 | 80 | 0.72±0.22 | 96 | 0.72±0.20 | 0.97 |
Tricuspid inflow E/A ratio | 91 | 1.03±0.44 | 108 | 1.01±0.27 | 0.62 | 94 | 0.95±0.25 | 107 | 1.01±0.27 | 0.07 | 80 | 1.12±0.50 | 96 | 1.07±0.26 | 0.34 |
Tricuspid annular tissue Doppler E′ velocity, cm/sec | 203 | 7.63±2.99 | 212 | 7.61±2.84 | 0.96 | 154 | 8.54±3.59 | 187 | 8.98±3.45 | 0.25 | 142 | 8.45±3.47 | 172 | 8.95±3.87 | 0.23 |
Tricuspid annular tissue Doppler A′ velocity, cm/sec | 95 | 6.39±2.04 | 115 | 6.87±2.51 | 0.13 | 93 | 7.39±2.5 | 113 | 7.64±2.39 | 0.47 | 75 | 6.85±2.26 | 99 | 6.79±2.24 | 0.88 |
E/E′ ratio | 196 | 12.2±5.9 | 206 | 11.5±5.4 | 0.26 | 148 | 11.3±4.9 | 181 | 10.2±4.1 | 0.02 | 138 | 11.5±5.1 | 169 | 11.0±4.7 | 0.30 |
Presence of pulmonary vein flow reversal | 212 | 17 (8%) | 216 | 46 (21%) | <0.001 | 157 | 18 (12%) | 191 | 33 (17%) | 0.13 | 135 | 9 (7%) | 176 | 12 (7%) | 1.00 |
Myocardial Performance Index or Tei Index | |||||||||||||||
Blood flow Doppler calculation | 200 | 0.38±0.18 | 198 | 0.58±0.25 | <0.001 | 150 | 0.39±0.18 | 184 | 0.49±0.20 | <0.001 | 131 | 0.44±0.16 | 168 | 0.44±0.18 | 0.96 |
Tissue Doppler calculation | 83 | 0.65±0.35 | 70 | 0.64±0.25 | 0.79 | 63 | 0.56±0.21 | 83 | 0.56±0.19 | 0.91 | 80 | 0.59±0.21 | 96 | 0.60±0.18 | 0.69 |
Data presented as mean±SD, median (inter-quartile range), or n (%). MBTS=modified Blalock-Taussig shunt; RVPAS=right ventricular-to-pulmonary artery shunt; RV=right ventricle