Right ventricular function in congenital heart defects assessed by regional wall motion.

OBJECTIVES

To develop a simple method to assess right ventricular function by angiography.

BACKGROUND

Conventional methods of evaluating right ventricular function are inaccurate, cumbersome, and expensive.

METHODS

We analyzed biplane right ventricular angiograms taken in the posterior-anterior and lateral projections using software to measure right ventricular volumes and regional wall motion in 78 patients with normal hearts (n = 29), atrial septal defects (ASD n = 13), pulmonary valve stenosis (PVS n = 21), and postoperative atrial switch patients (n = 15). We also measured the shortening fraction (SF) from the midtricuspid annulus to the septum and correlated various angiographic measurements with the right ventricular (RV) ejection fraction.

RESULTS

The volume-overloaded patients (ASD) had larger end diastolic volumes and increased SF compared with normal patients, while the pressure-loaded patients (PVS) had normal volumes and SF. The postoperative atrial switch patients had decreased systolic function and increased end diastolic volume. The SF for all of the patients correlated with the ejection fraction (r= 0.785, P<or= .0001).

CONCLUSIONS

A simple measurement of the end diastolic and end systolic distance from the midtricuspid annulus to the septum (SF) provides a good index of RV function by angiography and correlates well with RV ejection fraction.