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Impaired Right and Left Ventricular Function in Asymptomatic Children with Repaired Tetralogy of Fallot by Two‐Dimensional Speckle Tracking Echocardiography Study
Author(s) -
Li Yuman,
Xie Mingxing,
Wang Xinfang,
Lu Qing,
Zhang Li,
Ren Pingping
Publication year - 2015
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12581
Subject(s) - tetralogy of fallot , asymptomatic , cardiology , medicine , ejection fraction , speckle tracking echocardiography , strain (injury) , strain rate , cardiac magnetic resonance imaging , magnetic resonance imaging , heart failure , radiology , heart disease , materials science , metallurgy
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 .