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Atrial Mechanics after Surgical Repair of Tetralogy of Fallot
Author(s) -
Hou Jia,
Yu Hongkui,
Wong Sophia J.,
Cheung Yiufai
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.12611
Subject(s) - cardiology , medicine , diastole , tetralogy of fallot , systole , speckle tracking echocardiography , doppler echocardiography , doppler imaging , heart disease , heart failure , ejection fraction , blood pressure
Background Ventricular diastolic dysfunction in patients with repaired tetralogy of Fallot ( TOF ) may affect atrial mechanics. This study aimed to explore right atrial ( RA ) and left atrial ( LA ) mechanics in repaired TOF patients and their relationship with ventricular diastolic function. Methods Fifty‐four patients (36 males), aged 17.8 ± 8.3 years, who had undergone TOF repair at 3.9 ± 3.3 years and 40 healthy subjects aged 16.9 ± 6.3 years (P = 0.57) were studied. Right and LA peak positive, peak negative, and total strain, strain rate at ventricular systole ( SR s ), early diastole ( SR ed ), and atrial contraction ( SR ac ), and electromechanical delay were determined using speckle tracking echocardiography ( STE ). Ventricular diastolic function was assessed by tissue Doppler imaging and STE . Ventricular volumes and pulmonary regurgitant volume were derived from 3D echocardiography. Results Compared with controls, patients had significantly lower RA and LA peak positive and total strain, SR s , SR ed , and SR ac (all P < 0.001). The timing of RA (178 ± 33 msec vs. 152 ± 17 msec, P < 0.001) and LA (170 ± 32 msec vs. 152 ± 24 msec, P = 0.006) electromechanical coupling (EMC) was significantly longer in patients than in controls. The RA total strain, SR s , SR ed , SR ac , and EMC correlated positively with corresponding LA parameters (all P < 0.001). The RA and LA total strain and SR ed were associated positively with diastolic annular velocities and strain rates of respective ventricles (all P < 0.05). The LA SR ed correlated negatively with pulmonary regurgitant volume (r = −0.33, P = 0.016) and RV end‐diastolic volume (r = −0.33, P = 0.015). Conclusion Mechanics of both atria are impaired in patients after repair of TOF and are associated with diastolic performance of the respective ventricles.