What Echocardiographic Measure Should Be Used to Assess Right Ventricular Function in Tetralogy of Fallot?

The assessment of right ventricular (RV) function in patients with congenital heart disease is the focus of significant research and clinical interest. The RV’s anterior position in the chest, complex geometric shape, and unique pattern of contractility make the assessment of RV function by conventional 2-dimensional parameters challenging [1–3]. In Tetralogy Of Fallot (TOF) in particular, investigators have studied multiple non-invasive measures to evaluate the RV’s systolic function, including Tricuspid Annular Plane Systolic Excursion (TAPSE), Fractional Area Change (FAC), isovolumic acceleration time, tissue doppler-derived tricuspid systolic velocity (S’), longitudinal peak systolic strain, stress echocardiography, and more recently three-dimensional echocardiography [4–6]. Although the use of these methods has been suggested in particular for the follow up of patients with TOF, pulmonary regurgitation, progressive RV dilation, and dysfunction, the clinical utility of certain parameters remains undefined.