Open AccessLeft Ventricular Stiffness in Adolescents and Young Adults with Repaired Tetralogy of Fallot
Author(s) -
Clement Kwong-man Yu,
Wilfred HingSang Wong,
Vivian Wingyi Li,
Yiufai Cheung
Publication year - 2017
Publication title -
scientific reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.24
H-Index - 213
ISSN - 2045-2322
DOI - 10.1038/s41598-017-01448-2
Subject(s) - cardiology , medicine , diastole , tetralogy of fallot , heart disease , blood pressure
Left ventricular (LV) remodeling after tetralogy of Fallot (TOF) repair may influence LV stiffness. We hypothesized that LV stiffness is altered after TOF repair and related to myocardial calibrated integrated backscatter (cIB) and LV diastolic myocardial deformation. Seventy-seven TOF patients and 80 controls were studied. LV stiffness was assessed by diastolic wall strain (DWS) as defined by (LVPW systole -LVPW diastole )/LVPW systole , where LVPW is LV posterior wall thickness, and stiffness index as defined by (E/ e /LV end-diastolic dimension), where E and e are respectively early diastolic transmitral inflow and mitral annular velocities. Septal and LVPW cIB and LV diastolic strain rates were determined. Patients had significantly lower DWS (p < 0.001), higher stiffness index (p < 0.001), and greater cIB (p < 0.001). LV DWS correlated negatively with LV stiffness index (r = −0.31, p < 0.001), septal cIB (r = −0.21, p = 0.01), E/ e ratio (r = −0.30, p < 0.001) and RV end-diastolic area (r = −0.31, p < 0.001), and positively with LV early (r = 0.33, p < 0.001) and late (r = 0.20, p = 0.01) diastolic strain rates and RV fractional area change (FAC) (r = 0.24, p = 0.003). Multivariate analysis revealed E/ e (β = −0.26, p = 0.008), RV end-diastolic area (β = −0.20, p = 0.02), and RV FAC (β = 0.18, p = 0.01) as significant correlates of DWS. Left ventricular stiffening occurs after TOF repair and is related to impaired LV diastolic myocardial deformation, myocardial cIB, and RV volume overload.