Right ventricular systolic function in hypoplastic left heart syndrome: A comparison of velocity vector imaging and magnetic resonance imaging

Hanna Ruotsalainen, Hannah Bellsham-Revell, Aaron Bell, Jaana Pihkala, Tiina Ojala*, John Simpson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Aims Velocity vector imaging (VVI) is an echocardiographic technique based on speckle tracking, which has been validated for the left ventricle (LV). It has not been validated to assess the systemic right ventricle (RV) in patients with hypoplastic left heart syndrome (HLHS). The aim of this study was to evaluate whether VVI measurements reliably reflect RV systolic function in patients with HLHS when compared with RV ejection fraction (EF) calculated using magnetic resonance imaging (MRI). Methods and results In this prospective study, 49 children with HLHS underwent transthoracic echocardiography and cardiac MRI under the same general anaesthetic as a part of routine assessment between the different stages of palliative surgery. Global RV fractional area change (FAC-VVI), strain (S), strain rate (SR), and peak systolic velocity (V) were analysed from the apical four-chamber view using the VVI technique. MRI-derived EF was calculated from a short-Axis cine stack of images. Intraand interobserver reproducibility was excellent for all VVI parameters (intraclass correlation coefficient .0.9). All VVI-derived parameters, except myocardial velocity, correlated with MRI-derived EF (FAC-VVI: R = 0.7, P < 0.001; S: R = 20.5, P < 0.001; SR: R = 0.5, P = 0.001, and V: R = 0.1, P = 0.4). Conclusions All VVI-derived parameters, except V, correlate with MRI-derived EF, with FAC being the best predictor of it. Reproducibility of all VVI parameters is excellent. VVI provides a useful tool for the follow-up of RV function during the staged treatment protocol for HLHS.

Original languageEnglish
Pages (from-to)687-692
Number of pages6
JournalEuropean Heart Journal Cardiovascular Imaging
Issue number6
Publication statusPublished - 1 Jun 2016
Externally publishedYes

Bibliographical note

Funding Information:
H.R., J.P., and T.O. acknowledge financial support from Kirsti and Tor Johansson Foundation, Helsinki, Finland; Finnish Cultural Foundation, North-Savo Regional Fund, Kuopio, Finland; and Foundation for Pediatric Research, Helsinki, Finland. J.M.S. acknowledges financial support from the UK Department of Health via the National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre award to Guy's & St Thomas' NHS Foundation Trust in partnership with King's College London and King's College Hospital NHS Foundation Trust.

Publisher Copyright:
© 2016 The Author.


  • Hypoplastic left heart syndrome
  • Magnetic resonance imaging
  • Myocardial function
  • Right ventricle
  • Velocity vector imaging


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