Comparing Two Methods for the Right Ventricle Evaluation in TOF Patients with Pulmonary Regurgitation Following Total Repair: Pulsed Doppler and Tissue Doppler Imaging

Abstract

Background: The Tei index is used to evaluate the overall performance of the right ventricle. The index can be measured with pulsed Doppler echocardiography (PW) and tissue Doppler imaging (TDI). Some studies show that severe pulmonary valve regurgitation (PR) can influence the Tei index calculated by the PW method. Objectives: The purpose of this study was to compare PW and TDI in calculating the Tei index in PR patients following TOF reconstruction. Methods: We evaluated 21 patients with severe PI who were reconstructed and 21 age-matched normal children. All the children went through PW or TDI. The intensity of Sa, Ea, Aa, IVCT, and the Tei index were calculated. Results: The mean age of the patients and controls was 3.8 ± 3.2 and 3.7 ± 2.7 years, respectively. There was no difference in the Tei index between healthy children and TOF patients calculated by the PW method (0.30 ± 0.10 vs. 0.35 ± 0.06; P = 0.059). However, TOF patients had a lower intensity of Sa, Ea, and Aa than healthy children. Furthermore, the isovolumic interval of both IVCT and IVRT was longer in TOF patients than in healthy children (43.53 ± 8.82 vs. 25.77 ± 10.14 and 87.73 ± 10.91 vs. 68.36 ± 8.96, respectively; P = 0.001 for both) but the S duration had no difference between the groups (265.1 ± 18.1 in TOF patients vs. 266.8 ± 28.0 in controls). The Tei index calculated by TDI was significantly higher in TOF patients than in healthy children (0.50 ± 0.10 vs. 0.36 ± 0.06; P = 0.001). Moreover, the Tei index calculated by TDI was higher than the Tei index calculated by PW in TOF patients (0.50 ± 0.10 vs. 0.30 ± 0.10; P = 0.001). Conclusions: TDI is a more accurate method for calculating the Tei index for evaluating the overall performance of the right ventricle in PR patients after TOF reconstruction, and the Tei index calculated through PW had limitations for this purpose.