Is biventricular vascular coupling a better indicator of ventriculo-ventricular interaction in congenital heart disease?

• Published in: Cardiology in the young 2021-12, Vol.31 (12), p.2009-2014
• Main Authors: Yang, Emily L, Kutty, Shelby, Soriano, Brian D, Mallenahalli, Sathish, Ferguson, Mark R, Lewin, Mark B, Buddhe, Sujatha
• Format: Article
• Language: English
• Subjects: Cardiac catheterization; Cardiovascular disease; Cardiovascular diseases; Children; Congenital diseases; Coronary artery disease; Correlation; Coupling; Echocardiography; Echocardiography and Scans; Ejection fraction; Heart; Heart diseases; Magnetic resonance imaging; Original Article; Pathology; Patients; Physiology; Subgroups; Ultrasonic imaging; Ventricle; Work stations
• ISSN: 1047-9511; 1467-1107
• DOI: 10.1017/S1047951121001426

Ventriculo-ventricular interactions are known to exist, though not well quantified. We hypothesised that the ventricular-vascular coupling ratio assessed by cardiovascular MRI would provide insight into this relationship. We also sought to compare MRI-derived ventricular-vascular coupling ratio to echocardiography and patient outcomes. Children with cardiac disease and biventricular physiology were included. Sanz's and Bullet methods were used to calculate ventricular-vascular coupling ratio by MRI and echocardiography, respectively. Subgroup analysis was performed for right and left heart diseases. Univariate and multivariate regressions were performed to determine associations with outcomes. A total of 55 patients (age 14.3 ± 2.5 years) were included. Biventricular ventricular-vascular coupling ratio by MRI correlated with each other (r = 0.41; p = 0.003), with respect to ventricle's ejection fraction (r = -0.76 to -0.88; p < 0.001) and other ventricle's ejection fraction (r = -0.42 to -0.47; p < 0.01). However, biventricular ejection fraction had only weak correlation with each other (r = 0.31; p = 0.02). Echo underestimated ventricular-vascular coupling ratio for the left ventricle (p < 0.001) with modest correlation to MRI-derived ventricular-vascular coupling ratio (r = 0.43; p = 0.002). There seems to be a weak correlation between uncoupled right ventricular-vascular coupling ratio with the need for intervention and performance on exercise testing (r = 0.33; p = 0.02). MRI-derived biventricular ventricular-vascular coupling ratio provides a better estimate of ventriculo-ventricular interaction in children and adolescents with CHD. These associations are stronger than traditional parameters and applicable to right and left heart conditions.