We read with interest the expert consensus statement “Targeted Neonatal Echocardiography in the Neonatal Intensive Care Unit: Practice Guidelines and Recommendations for Training” from the writing group of the American Society of Echocardiography in collaboration with the European Association of Echocardiography and the Association for European Pediatric Cardiologists by Mertens et al . In our opinion, this is an excellent statement describing the current indications for targeted neonatal echocardiography (TNE), defining recommendations for the performance of TNE, and proposing training requirements for operators performing and interpreting TNE.
In section 2.1.3c, the authors provide a detailed description of the evaluation of right ventricular (RV) function in the neonatal setting. The authors clearly state that there is a need for a detailed evaluation of tricuspid annular plane systolic excursion in the neonatal population, and there is a need for a further evaluation of tissue Doppler parameters such as tricuspid annular peak systolic velocity in newborns. For the convenience of the audience of the Journal of the American Society of Echocardiography and especially for centers performing TNE, we want to add that quite recently, our group published normal values of tricuspid annular plane systolic excursion with Z -scores for both preterm and term neonates. In addition, normal values of tricuspid annular peak systolic velocity are available for the neonatal population.
We want to thank Mertens et al . for addressing the need for careful and systematic evaluation of the right ventricle in the neonatal population. In our opinion, RV function should be carefully investigated in both patients with congenital heart disease and in those without congenital heart disease. We agree with the authors that some amount of expertise is necessary to qualitatively investigate RV function. We hope that with increasingly available normal reference values and Z -scores for this population, quantification of RV function will become an easily available tool for all sonographers. We hope that in future revisions of the expert consensus statement for TNE, reference will be made to the published normal values of tricuspid annular plane systolic excursion and tricuspid annular peak systolic velocity values.