Right Ventricular Flow Dynamics in Dilated Right Ventricles: Energy Loss Estimation Based on Blood Speckle Tracking Echocardiography-A Pilot Study in Children

Wadi Mawad; Lasse Løvstakken; Solveig Fadnes; Thomas Grønli; Patrick Segers; Luc Mertens; Siri Ann Nyrnes

doi:10.1016/j.ultrasmedbio.2021.02.004

Right Ventricular Flow Dynamics in Dilated Right Ventricles: Energy Loss Estimation Based on Blood Speckle Tracking Echocardiography-A Pilot Study in Children

Ultrasound Med Biol. 2021 Jun;47(6):1514-1527. doi: 10.1016/j.ultrasmedbio.2021.02.004. Epub 2021 Mar 6.

Authors

Wadi Mawad¹, Lasse Løvstakken², Solveig Fadnes², Thomas Grønli², Patrick Segers³, Luc Mertens⁴, Siri Ann Nyrnes⁵

Affiliations

¹ The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Paediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada. Electronic address: wadi.mawad@mcgill.ca.
² Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
³ Biommeda, University of Ghent, Ghent, Belgium.
⁴ The Hospital for Sick Children, Toronto, Ontario, Canada.
⁵ Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Children's Clinic, St. Olav's University Hospital, Trondheim, Norway.

PMID: 33685744
DOI: 10.1016/j.ultrasmedbio.2021.02.004

Abstract

Using blood speckle tracking (BST) based on high-frame-rate echocardiography (HFRE), we compared right ventricle (RV) flow dynamics in children with atrial septal defects (ASDs) and repaired tetralogy of Fallot (rTOF). Fifty-seven children with rTOF with severe pulmonary insufficiency (PI) (n = 21), large ASDs (n = 11) and healthy controls (CTL, n = 25) were included. Using a flow phantom, we studied the effects of imaging plane and smoothing parameters on 2-D energy loss (EL). RV diastolic EL was similar in ASD and rTOF, but both were greater than in CTL. Locations of high EL were similar in all groups in systole, occurring in the RV outflow tract and around the tricuspid valve leaflets in early diastole. An additional apical early diastolic area of EL was noted in rTOF, corresponding to colliding tricuspid inflow and PI. The flow phantom revealed that EL varied with imaging plane and smoothing settings but that the EL trend was preserved if kept consistent.

Keywords: Blood flow imaging; Blood speckle tracking; Energy loss; Flow dynamics; High-frame-rate imaging.

MeSH terms

Child
Child, Preschool
Dilatation, Pathologic
Echocardiography / methods*
Female
Heart Septal Defects, Atrial / physiopathology*
Heart Ventricles / diagnostic imaging*
Heart Ventricles / pathology
Heart Ventricles / physiopathology*
Humans
Infant
Male
Physical Phenomena
Pilot Projects
Postoperative Complications / physiopathology*
Pulmonary Valve Insufficiency / physiopathology*
Regional Blood Flow
Tetralogy of Fallot / surgery*