Impaired Right and Left Ventricular Function in Asymptomatic Children with Repaired Tetralogy of Fallot by Two‐Dimensional Speckle Tracking Echocardiography Study

Background Early detection of right ventricular ( RV ) and left ventricular ( LV ) dysfunction in patients with repaired tetralogy of Fallot ( TOF ) is essential because dysfunction is correlated with a poor clinical outcome. The aim of this study was to assess RV and LV function in asymptomatic children with repaired TOF by two‐dimensional ultrasound speckle tracking echocardiography ( STE ). Methods Fifty‐six asymptomatic children with a preserved biventricular ejection fraction ( EF ) after repair of TOF and 35 healthy control subjects were studied. RV and LV strain and strain rate were measured by STE . RVEF and pulmonary regurgitation ( PR ) were assessed using cardiac magnetic resonance imaging. Results Compared with the control subjects, RV regional longitudinal strain and strain rate and global longitudinal strain ( GLS ) and strain rate ( GLSR ) were impaired in children with repaired TOF . Likewise, LV circumferential and radial strain and strain rate were reduced in patients with TOF . In contrast, longitudinal strain and strain rate did not differ between the groups. RV and LV GLSR were correlated with postoperative follow‐up period (r 1  = −0.44; r 2  = −0.48). RV GLS and GLSR were associated with RVEF (r 1  = 0.64; r 2  = 0.60) and PR (r 1  = −0.48; r 2  = −0.49). LV circumferential strain rate was related to PR (r = −0.45). Conclusions STE can identify abnormalities that may represent early impairment of RV and LV systolic function in postoperative TOF patients with a preserved EF . PR is associated with decreased biventricular performance in repaired patients. STE ‐derived strain and strain rate may be useful indices for detecting the early deterioration of biventricular performance in patients with TOF .