Evaluation of Right Ventricular Function by Echocardiography in Children with Congenital Heart Disease who have both Reversible and Irreversible Pulmonary Hypertension in Comparison to Healthy Children

Abstract

Background: Children with congenital heart disease (CHD) frequently have right ventricular (RV) dysfunction, especially when pulmonary hypertension (PH) is present. For the purpose of identifying, evaluating, and tracking CHD patients with PH, transthoracic echocardiography (TTE) is essential. The purpose of the current study was to compare RV function as measured by TTE between children in good health and CHD patients with PH. Methods: Patients with CHD who had been diagnosed with PH by TTE and verified by cardiac catheterization made up the case group. Children with normal echocardiograms were part of the control group. Based on predetermined criteria, 80 patients in total were enrolled. Results: There were 40 cases and 40 controls in the study. With the exception of RV subcostal wall thickness, echocardiographic measurements showed substantial differences between the case and control groups, with the case group having larger RV dimensions. The case group had considerably poorer RV systolic function metrics, such as tricuspid annular planar systolic excursion (TAPSE) and tricuspid annular systolic velocity (S'). Deceleration time (DT), E/A ratio, and E/e' were among the RV diastolic function metrics that differed significantly across the groups. The case group had a considerably higher tissue Doppler imaging-derived myocardial performance index (TD MPI), a measure of RV global function. Conclusions: PH severity is correlated with echocardiographic assessment of RV function in CHD children with PH, including TAPSE, S', TD MPI, E/A ratio, E/e', and DT. As an alternative to right cardiac catheterization, this evaluation can help identify PH severity early on before irreversible alterations take place. Keywords: RV function in children, Pulmonary hypertension, Transthoracic echocardiography