Quantitation of the global right ventricular function in children with normal heart and congenital heart disease: A right ventricular myocardial performance index

Although the assessment of right ventricular (RV) function is important in the clinical management of children with congenital heart disease, availabl e imaging techniques have been limited because of the complex geometry of t he right ventricle. A new Doppler index combining systolic and diastolic ti me intervals (the Tei index) has been reported to be useful for the assessm ent of global RV function in adults. However, normal values in children, ag e-related changes, and the clinical utility of the Tei index with regard to congenital heart disease have not been demonstrated. The purpose of this s tudy was to prospectively assess RV function in children with normal heart and congenital heart disease using the Tei index. The subjects included 150 healthy children and 43 patients with congenital heart disease (35 patient ?; with atrial septal defects and 8 patients who had had a Senning operatio n). The index was defined as the sum of isovolumetric contraction time and isovolumetric relaxation time divided by ejection time and was measured fro m conventional RV outflow and inflow Doppler velocity profiles. The Tei ind ex was not affected by age in healthy children (0.24 +/- 0.04). There was a significant difference in index rating between patients who had had a Senn ing operation (0.58 +/- 0.09) and healthy children (p < 0.01), but there wa s no significant difference between children with atrial septal defect (0.2 5 +/- 0.13) and healthy children. The Tei index is a feasible approach to u se when assessing global RV function in children with congential heart dise ase.