ORIGINAL RESEARCH article
Front. Surg.
Sec. Thoracic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1685170
Resting Right Ventricular Function in Pectus Excavatum: Do Haller Index and Age Matter?
Provisionally accepted- 1Eunpyeong St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
- 2CHA University Bundang Medical Center, Seongnam-si, Republic of Korea
- 3Eulji University Uijeongbu Eulji Medical Center, Uijeongbu-si, Republic of Korea
- 4The Catholic University of Korea Incheon Saint Mary's Hospital, Incheon, Republic of Korea
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Pectus excavatum (PE) is associated with compression of intrathoracic structures, potentially impairing right ventricular (RV) function. The Haller index (HI) is widely used to quantify the severity of deformities; however, its functional correlation remains uncertain. This study aimed to evaluate whether HI and patient age were associated with resting RV systolic function in patients with PE. Methods: This retrospective cohort study analyzed 67 patients with PE who underwent surgical correction and had complete preoperative echocardiographic data between January 2013 and January 2024. RV function was assessed using the fractional area change (FAC) and tricuspid annular plane systolic excursion (TAPSE). Patients were stratified by HI severity (<3.2, 3.2–3.4, ≥3.5) and age (≤13 vs >13 years). Receiver operating characteristic (ROC) analysis and multivariate regression were used to determine predictors of RV dysfunction. Results: The mean HI was 4.09 (± 0.99), and the mean age was 15.85 (± 4.96) years. Neither HI nor age significantly correlated with FAC (HI: r = –0.04, p = 0.749; age: r = 0.09, p = 0.455) or TAPSE (HI: r = –0.05, p = 0.685; age: r = 0.14, p = 0.245). Subgroup and regression analyses confirmed that neither HI nor age were predictive of impaired RV systolic function. ROC analysis demonstrated the poor discriminatory power of age for reduced FAC (area under the curve = 0.478). Conclusion: Resting RV systolic function was not significantly influenced by HI or age in patients with PE. These findings highlight the need for a functional, individualized approach beyond anatomical metrics for surgical evaluation.
Keywords: Pectus excatavum, Right ventricular function, Haller index, transthoracic echocardiography, TAPSE, fractional area change
Received: 13 Aug 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Choi, Rim, Lee, Ahn and Jeong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jin Yong Jeong, jeong74@catholic.ac.kr
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.