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Comprehensive Evaluation of Pediatric Patients with Ebstein Anomaly Requires Both Echocardiography and Cardiac Magnetic Resonance Imaging

With the trend towards childhood surgery in patients with Ebstein anomaly (EA), thorough imaging is crucial for patient selection. This study aimed to assess biventricular function by echocardiography and cardiac magnetic resonance (CMR) and compare EA severity classifications. Twenty-three patients...

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Autores principales: Geerdink, Lianne M., van Everdingen, Wouter M., Kuipers, Irene M., Fejzic, Zina, du Marchie Sarvaas, Gideon J., Frerich, Stefan, ter Heide, Henriëtte, Helbing, Willem A., de Korte, Chris L., Habets, Jesse, Kapusta, Livia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9852135/
https://www.ncbi.nlm.nih.gov/pubmed/35727332
http://dx.doi.org/10.1007/s00246-022-02948-3
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author Geerdink, Lianne M.
van Everdingen, Wouter M.
Kuipers, Irene M.
Fejzic, Zina
du Marchie Sarvaas, Gideon J.
Frerich, Stefan
ter Heide, Henriëtte
Helbing, Willem A.
de Korte, Chris L.
Habets, Jesse
Kapusta, Livia
author_facet Geerdink, Lianne M.
van Everdingen, Wouter M.
Kuipers, Irene M.
Fejzic, Zina
du Marchie Sarvaas, Gideon J.
Frerich, Stefan
ter Heide, Henriëtte
Helbing, Willem A.
de Korte, Chris L.
Habets, Jesse
Kapusta, Livia
author_sort Geerdink, Lianne M.
collection PubMed
description With the trend towards childhood surgery in patients with Ebstein anomaly (EA), thorough imaging is crucial for patient selection. This study aimed to assess biventricular function by echocardiography and cardiac magnetic resonance (CMR) and compare EA severity classifications. Twenty-three patients (8–17 years) underwent echocardiography and CMR. Echocardiographic parameters included tricuspid annular plane systolic excursions (TAPSE), fractional area change of the functional right ventricle (fRV-FAC), fRV free wall peak systolic myocardial velocity (fRVs’), and tricuspid regurgitation (TR). End-diastolic and end-systolic volume (EDV resp. ESV), fRV- and LV ejection fraction (EF) and TR were obtained by CMR. EA severity classifications included displacement index, Celermajer index and the total-right/left-volume index. Median fRV-FAC was 38% (IQR 33–42). TAPSE and fRVs’ were reduced in 39% and 75% of the patients, respectively. Echocardiographic TR was visually graded as mild, moderate, or severe in nine, six and eight patients, respectively. By CMR, median fRVEF was 49% (IQR 36–58) and TR was graded as mild, moderate, or severe in nine, twelve and two patients, respectively. In 70% of cases, fRV-EDV was higher than LV-EDV. LVEF was decreased in 17 cases (74%). There was excellent correlation between echocardiography-derived fRV-FAC and CMR-derived fRVEF (rho = 0.812, p < 0.001). While echocardiography is a versatile tool in the complex geometry of the Ebstein heart, it has limitations. CMR offers a total overview and has the advantage of reliable volume assessment of both ventricles. Comprehensive evaluation of pediatric patients with EA may therefore require a synergistic implementation of echocardiography and CMR. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00246-022-02948-3.
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spelling pubmed-98521352023-01-21 Comprehensive Evaluation of Pediatric Patients with Ebstein Anomaly Requires Both Echocardiography and Cardiac Magnetic Resonance Imaging Geerdink, Lianne M. van Everdingen, Wouter M. Kuipers, Irene M. Fejzic, Zina du Marchie Sarvaas, Gideon J. Frerich, Stefan ter Heide, Henriëtte Helbing, Willem A. de Korte, Chris L. Habets, Jesse Kapusta, Livia Pediatr Cardiol Original Article With the trend towards childhood surgery in patients with Ebstein anomaly (EA), thorough imaging is crucial for patient selection. This study aimed to assess biventricular function by echocardiography and cardiac magnetic resonance (CMR) and compare EA severity classifications. Twenty-three patients (8–17 years) underwent echocardiography and CMR. Echocardiographic parameters included tricuspid annular plane systolic excursions (TAPSE), fractional area change of the functional right ventricle (fRV-FAC), fRV free wall peak systolic myocardial velocity (fRVs’), and tricuspid regurgitation (TR). End-diastolic and end-systolic volume (EDV resp. ESV), fRV- and LV ejection fraction (EF) and TR were obtained by CMR. EA severity classifications included displacement index, Celermajer index and the total-right/left-volume index. Median fRV-FAC was 38% (IQR 33–42). TAPSE and fRVs’ were reduced in 39% and 75% of the patients, respectively. Echocardiographic TR was visually graded as mild, moderate, or severe in nine, six and eight patients, respectively. By CMR, median fRVEF was 49% (IQR 36–58) and TR was graded as mild, moderate, or severe in nine, twelve and two patients, respectively. In 70% of cases, fRV-EDV was higher than LV-EDV. LVEF was decreased in 17 cases (74%). There was excellent correlation between echocardiography-derived fRV-FAC and CMR-derived fRVEF (rho = 0.812, p < 0.001). While echocardiography is a versatile tool in the complex geometry of the Ebstein heart, it has limitations. CMR offers a total overview and has the advantage of reliable volume assessment of both ventricles. Comprehensive evaluation of pediatric patients with EA may therefore require a synergistic implementation of echocardiography and CMR. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00246-022-02948-3. Springer US 2022-06-21 2023 /pmc/articles/PMC9852135/ /pubmed/35727332 http://dx.doi.org/10.1007/s00246-022-02948-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Geerdink, Lianne M.
van Everdingen, Wouter M.
Kuipers, Irene M.
Fejzic, Zina
du Marchie Sarvaas, Gideon J.
Frerich, Stefan
ter Heide, Henriëtte
Helbing, Willem A.
de Korte, Chris L.
Habets, Jesse
Kapusta, Livia
Comprehensive Evaluation of Pediatric Patients with Ebstein Anomaly Requires Both Echocardiography and Cardiac Magnetic Resonance Imaging
title Comprehensive Evaluation of Pediatric Patients with Ebstein Anomaly Requires Both Echocardiography and Cardiac Magnetic Resonance Imaging
title_full Comprehensive Evaluation of Pediatric Patients with Ebstein Anomaly Requires Both Echocardiography and Cardiac Magnetic Resonance Imaging
title_fullStr Comprehensive Evaluation of Pediatric Patients with Ebstein Anomaly Requires Both Echocardiography and Cardiac Magnetic Resonance Imaging
title_full_unstemmed Comprehensive Evaluation of Pediatric Patients with Ebstein Anomaly Requires Both Echocardiography and Cardiac Magnetic Resonance Imaging
title_short Comprehensive Evaluation of Pediatric Patients with Ebstein Anomaly Requires Both Echocardiography and Cardiac Magnetic Resonance Imaging
title_sort comprehensive evaluation of pediatric patients with ebstein anomaly requires both echocardiography and cardiac magnetic resonance imaging
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9852135/
https://www.ncbi.nlm.nih.gov/pubmed/35727332
http://dx.doi.org/10.1007/s00246-022-02948-3
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