05 Mar Intracardiac Flow Analysis of the Right Ventricle in Pediatric Patients With Repaired Tetralogy of Fallot Using a Novel Color Doppler Velocity Reconstruction
Repaired tetralogy of Fallot (RTOF) patients often develop right ventricular (RV) dysfunction due to chronic pulmonary regurgitation, but detecting early changes in intracardiac flow remains challenging. While advanced imaging techniques like four-dimensional cardiac magnetic resonance (CMR) provide insights into vorticity and flow energy loss (FEL), they are not widely available. In this study, we evaluated whether Doppler Velocity Reconstruction (DoVeR)—a vendor-independent method for color Doppler flow reconstruction—could measure RV intracardiac flow abnormalities in RTOF patients. In a study of 20 RTOF patients and age-matched controls, DoVeR revealed higher diastolic vortex strength (VS) and FEL in RTOF patients (P < .002 for both metrics). Notably, greater FEL and VS correlated with lower right and left ventricular ejection fractions (r ≈ -0.5, P < .04), indicating a link between abnormal flow dynamics and declining heart function. Additionally, mean diastolic FEL and VS were strongly associated with reduced exercise capacity (r ≈ -0.7, P < .01), suggesting their relevance in assessing functional status. These results demonstrate that DoVeR can detect intracardiac flow abnormalities in RTOF patients using widely available echocardiography. With its ability to track VS and FEL over time, this technique could serve as a practical tool for monitoring RV function, guiding clinical decisions, and improving long-term care in congenital heart disease.
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