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Impact of surgical correction of tetralogy of fallot on short-term right and left ventricular function as determined by 2-dimensional speckle tracking echocardiography.

Li Y, Wang X, Lv Q, Wang J, Yang Y, He L, Yuan L, Zhang L, Xie M - Medicine (Baltimore) (2016)

Bottom Line: LV deformation parameters were unchanged in all patients.The preoperative RV and LV deformational indices are the determinant of postoperative biventricular function improvement.STE appears to be a valuable tool for assessment of biventricular function after congenital heart disease surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

ABSTRACT
Right ventricular (RV) and left ventricular (LV) dysfunction is an important determinant of poor clinical status in repaired patients with tetralogy of Fallot (TOF). The purpose of our study is to assess the impact of surgical repair on short-term RV and LV function by 2-dimensional speckle tracking echocardiography (STE).Sixty-seven patients (median age 12 months) with TOF before and 6 months after repair and 35 healthy subjects were studied. The patients were divided into the younger (age at surgery ≤12 months) and older (age at surgery >12 months) subgroups. RV and LV global longitudinal systolic strain and strain rate (SR), and LV global circumferential and radial systolic strain and SR were measured by STE. After repair, RV longitudinal strain and SR increased in the younger patients, whereas RV longitudinal SR was decreased in the older patients. LV deformation parameters were unchanged in all patients. In the multivariate analysis, patients with better RV and LV deformation parameters preoperatively were identified to have better RV and LV strain and SR postoperatively (P < 0.05 for all). The surgical approach of the pulmonary valve ring was predictive of RV and LV systolic function postoperatively (P < 0.05 for all).After TOF repair, short-term RV function improvement is identified in the younger but not in the older patients, whereas LV function is unchanged in all patients. The preoperative RV and LV deformational indices are the determinant of postoperative biventricular function improvement. STE appears to be a valuable tool for assessment of biventricular function after congenital heart disease surgery.

No MeSH data available.


Related in: MedlinePlus

Right ventricular longitudinal (A, B), left ventricular radial (C, D) and circumferential (E, F) strain and strain rate curves in patients with tetralogy of Fallot. The white dotted curves represent the global longitudinal and circumferential strain and strain rate. GCS = global circumferential systolic strain, GCSRs = global circumferential systolic strain rate, GLS = global longitudinal systolic strain, GLSRs = global longitudinal systolic strain rate.
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Figure 1: Right ventricular longitudinal (A, B), left ventricular radial (C, D) and circumferential (E, F) strain and strain rate curves in patients with tetralogy of Fallot. The white dotted curves represent the global longitudinal and circumferential strain and strain rate. GCS = global circumferential systolic strain, GCSRs = global circumferential systolic strain rate, GLS = global longitudinal systolic strain, GLSRs = global longitudinal systolic strain rate.

Mentions: Two-dimensional grayscale images of subjects at a frame rate of 60 to 90 frames/s were obtained from the apical 4-chamber view and parasternal LV short-axis view at mid-ventricular level. RV and LV longitudinal strain and SR were measured from the apical 4-chamber view; LV radial strain and SR, and circumferential strain and SR were measured from the LV mid-ventricular short-axis images. All images were stored for off-line analysis (EchoPAC, version BT06; GE-Vingmed, Norway). For speckle tracking analysis, the RV and LV endocardial borders were manually traced in the end-systolic frame at the point in the cardiac cycle in which the endocardial border was the clearest. The region of interest in each image was automatically generated. The position of the region of interest and its width was adjusted manually when the speckle tracking appeared to be poor. The software automatically tracked and accepted segments of good tracking quality and rejected poorly tracked segments. When all segments of the RV or LV were accepted, the RV and LV longitudinal strain and SR curves and the LV radial and circumferential strain and SR curves were automatically generated. RV and LV global longitudinal systolic strain (GLS) and strain rate (GLSRs), and LV global circumferential systolic strain (GCS) and strain rate (GCSRs) were automatically obtained from the strain and strain rate curves. LV global radial systolic strain (GRS) and strain rate (GRSRs) referred to the average of the LV 6 segments at the mid-ventricular short-axis images. Representative examples of RV and LV strain and SR curves in patients with TOF are shown in Figure 1. All measurements were performed 3 times, and the mean value was used for analysis.


Impact of surgical correction of tetralogy of fallot on short-term right and left ventricular function as determined by 2-dimensional speckle tracking echocardiography.

Li Y, Wang X, Lv Q, Wang J, Yang Y, He L, Yuan L, Zhang L, Xie M - Medicine (Baltimore) (2016)

Right ventricular longitudinal (A, B), left ventricular radial (C, D) and circumferential (E, F) strain and strain rate curves in patients with tetralogy of Fallot. The white dotted curves represent the global longitudinal and circumferential strain and strain rate. GCS = global circumferential systolic strain, GCSRs = global circumferential systolic strain rate, GLS = global longitudinal systolic strain, GLSRs = global longitudinal systolic strain rate.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979818&req=5

Figure 1: Right ventricular longitudinal (A, B), left ventricular radial (C, D) and circumferential (E, F) strain and strain rate curves in patients with tetralogy of Fallot. The white dotted curves represent the global longitudinal and circumferential strain and strain rate. GCS = global circumferential systolic strain, GCSRs = global circumferential systolic strain rate, GLS = global longitudinal systolic strain, GLSRs = global longitudinal systolic strain rate.
Mentions: Two-dimensional grayscale images of subjects at a frame rate of 60 to 90 frames/s were obtained from the apical 4-chamber view and parasternal LV short-axis view at mid-ventricular level. RV and LV longitudinal strain and SR were measured from the apical 4-chamber view; LV radial strain and SR, and circumferential strain and SR were measured from the LV mid-ventricular short-axis images. All images were stored for off-line analysis (EchoPAC, version BT06; GE-Vingmed, Norway). For speckle tracking analysis, the RV and LV endocardial borders were manually traced in the end-systolic frame at the point in the cardiac cycle in which the endocardial border was the clearest. The region of interest in each image was automatically generated. The position of the region of interest and its width was adjusted manually when the speckle tracking appeared to be poor. The software automatically tracked and accepted segments of good tracking quality and rejected poorly tracked segments. When all segments of the RV or LV were accepted, the RV and LV longitudinal strain and SR curves and the LV radial and circumferential strain and SR curves were automatically generated. RV and LV global longitudinal systolic strain (GLS) and strain rate (GLSRs), and LV global circumferential systolic strain (GCS) and strain rate (GCSRs) were automatically obtained from the strain and strain rate curves. LV global radial systolic strain (GRS) and strain rate (GRSRs) referred to the average of the LV 6 segments at the mid-ventricular short-axis images. Representative examples of RV and LV strain and SR curves in patients with TOF are shown in Figure 1. All measurements were performed 3 times, and the mean value was used for analysis.

Bottom Line: LV deformation parameters were unchanged in all patients.The preoperative RV and LV deformational indices are the determinant of postoperative biventricular function improvement.STE appears to be a valuable tool for assessment of biventricular function after congenital heart disease surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

ABSTRACT
Right ventricular (RV) and left ventricular (LV) dysfunction is an important determinant of poor clinical status in repaired patients with tetralogy of Fallot (TOF). The purpose of our study is to assess the impact of surgical repair on short-term RV and LV function by 2-dimensional speckle tracking echocardiography (STE).Sixty-seven patients (median age 12 months) with TOF before and 6 months after repair and 35 healthy subjects were studied. The patients were divided into the younger (age at surgery ≤12 months) and older (age at surgery >12 months) subgroups. RV and LV global longitudinal systolic strain and strain rate (SR), and LV global circumferential and radial systolic strain and SR were measured by STE. After repair, RV longitudinal strain and SR increased in the younger patients, whereas RV longitudinal SR was decreased in the older patients. LV deformation parameters were unchanged in all patients. In the multivariate analysis, patients with better RV and LV deformation parameters preoperatively were identified to have better RV and LV strain and SR postoperatively (P < 0.05 for all). The surgical approach of the pulmonary valve ring was predictive of RV and LV systolic function postoperatively (P < 0.05 for all).After TOF repair, short-term RV function improvement is identified in the younger but not in the older patients, whereas LV function is unchanged in all patients. The preoperative RV and LV deformational indices are the determinant of postoperative biventricular function improvement. STE appears to be a valuable tool for assessment of biventricular function after congenital heart disease surgery.

No MeSH data available.


Related in: MedlinePlus