Background .– Right ventricular (RV) function is a major determinant of prognosis in patients (pts) with operated tetralogy of Fallot (ToF), but its evaluation remains challenging. We compared results from speckle tracking (2D strain) and conventional echocardiogram (echo) with those of magnetic resonance imaging (MRI).

Methods .– Transthoracic echo and MRI were performed in all pts. Systolic RV function was analysed in the apical 4-chamber view by % RV surface shortening, tricuspid annular plane systolic excursion (TAPSE) and 2D strain. Longitudinal maximal systolic strain was evaluated. Measurements were performed off-line by two independent observers. All echo results were compared to RV volumes and RV ejection fraction (EF) estimated by MRI.

Results .– Ten pts, (seven males), aged 11–31yrs (20.7 ± 6.6), operated on 20 ± 5 yrs before for a ToF were included. All pts had significant pulmonary valvular regurgitation. All RV systolic function parameters were decreased in all pts: 38 ± 8% for RV surface shortening, 17.9 ± 3 mm for TAPSE, 42 ± 11% for RVEF by MRI. Global RV systolic strain was –19.3 ± 2.1%, free wall strain was –20.5 ± 3.1% and septal wall strain was –18 ± 2.7% on average for the whole group. TAPSE and % RV surface shortening were not correlated with RV volumes or RVEF, whereas global 2D strain correlated quite well with RVEF: r 2 = 0.48, P < 0.05. Feasibility, intra- and interobserver reproducibility of 2D strain were adequate.

Conclusions .– Speckle tracking (2D strain) is a new and promising method of estimating RV systolic function in pts operated on for ToF. Its prognostic value remains to be determined in larger series of pts.