alexa Non-Invasive Imaging for Congenital Heart Disease: Rece
ISSN: 2155-9880

Journal of Clinical & Experimental Cardiology
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Review Article

Non-Invasive Imaging for Congenital Heart Disease: Recent Innovations in Transthoracic Echocardiography

Martin Koestenberger1*, Mark K. Friedberg2, William Ravekes3, Eirik Nestaas4 and Georg Hansmann5,6
1Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Austria
2The Labatt Family Heart Center, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
3Division of Pediatric Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
4Department of Paediatrics, Oslo Vestfold Hospital Trust, Tønsberg, Norway
5Department of Cardiology, Children’s Hospital Boston, Harvard Medical School, Boston, MA, USA
6Department of Pediatric Cardiology and Critical Care, Hannover Medical School, Hannover, Germany
Corresponding Author : Martin Koestenberger, MD, PhD
Department of Pediatrics, Medical University Graz
Auenbruggerplatz 30, A-8036 Graz, Austria
Tel: +43 316 385 2605
E-mail: [email protected]
Received: October 27, 2011; Accepted: January 20, 2012; Published: June 15, 2012
Citation: Koestenberger M, Friedberg MK, Ravekes W, Nestaas E, Hansmann G (2012) Non-Invasive Imaging for Congenital Heart Disease: Recent Innovations in Transthoracic Echocardiography. J Clin Exp Cardiolog S8:002. doi:10.4172/2155-9880.S8-002
Copyright: © 2012 Koestenberger M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Transthoracic echocardiography (TTE) is an important tool for diagnosis and follow-up of patients with congenital heart disease (CHD). Appropriate use of TTE can reduce the need for more invasive and complex modalities, such as cardiac catheterization and cardiac magnetic resonance imaging. New echocardiographic techniques have emerged for the assessment of ventricular systolic and diastolic function: Tissue Doppler imaging, tissue tracking, strain and strain rate imaging, vector velocity imaging (VVI), myocardial performance index, myocardial acceleration during isovolumic contraction (IVA), the ratio of systolic to diastolic duration (S/D ratio), and other measurements of systolic right ventricular (RV) function like tricuspid annular plane systolic excursion (TAPSE). These modalities may become valuable indicators of ventricular performance, compliance and disease progression, with the caveat of preload-dependency of the variables measured. In addition, three-dimensional (3D) echocardiography for the assessment of cardiac anatomy, valvular function, device position, ventricular volumes and ejection fraction is integrated into routine clinical care. In this review, we discuss the potential use and limitations of these new echocardiographic techniques in patients with CHD. A particular focus is on the echocardiographic assessment of right ventricular (RV) function by means of tissue Doppler imaging, tissue tracking, and three-dimensional imaging, in conditions associated with increased right ventricular volume or pressure load.


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