Contraction Pattern of the Systemic Right VentricleShift From Longitudinal to Circumferential Shortening and Absent Global Ventricular Torsion
Eirik Pettersen, MD*,1,*,
Thomas Helle-Valle, MD ,1,
Thor Edvardsen, MD, PhD*,
Harald Lindberg, MD, PhD ,
Hans-Jørgen Smith, MD, PhD ,
Bjarne Smevik, MD,
Otto A. Smiseth, MD, PhD* and
Kai Andersen, MD, PhD
* Department of Cardiology, Faculty of Medicine, University of Oslo and Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway
Institute of Surgical Research, Faculty of Medicine, University of Oslo and Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway
Department of Thoracic and Cardiovascular Surgery, University of Oslo and Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway
Department of Radiology, Faculty of Medicine, University of Oslo and Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway.
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Figure 1 Assessment of Ventricular Geometry and Sampling Sites for TDI Measurements
Echocardiographic parasternal short-axis images from a Senning-operated patient with transposition of the great arteries demonstrating (A) measurements for calculation of the ratio between systolic right (RVd) and left ventricular internal diameter (LVd), and (B) assessment of radius of curvature (r). Panels C and D show sampling sites for strain and strain rate measurements in the apical 4-chamber and parasternal short-axis view (only free wall midventricular sampling sites shown). IVS = interventricular septum; LV = left ventricle; RV = right ventricle; TDI = tissue Doppler imaging; V = probe orientation marker.
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Figure 2 Myocardial Shortening Patterns
Representative strain curves from the systemic RV of a patient with transposition of the great arteries compared with curves from the RV and LV of a normal subject. ECG = electrocardiogram; other abbreviations as in Figure 1.
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Figure 3 Agreement Between Strain by TDI and MRI
Bland-Altman plot showing agreement between strain measured by TDI and MRI. MRI = magnetic resonance imaging; TDI = tissue Doppler imaging.
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Figure 4 Basal and Apical Systolic Rotation
Schematic depiction of basal and apical rotation during systole in the normal LV and the systemic RV. Arrowheads indicate the direction and magnitude of rotation. Abbreviations as in Figure 1.
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