Speckle tracking echocardiography before and after Surgical pulmonary valve replacement in Tetralogy of Fallot patients: Can STE elucidate early left ventricular dysfunction?

IF 0.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
G. Ajami, Fathi Alwasabi, N. Mehdizadegan, M. Edraki, H. Mohammadi, A. Amirghofran, Bahram Ghasemzade, K. Keshavarz, H. Amoozgar, H. Arabi, A. Naghshzan, M. Borzouee, Farah Peiravian
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引用次数: 2

Abstract

Objectives: TOF is the most common cyanotic CHD. We investigated left ventricular (LV) function after surgical pulmonary valve replacement (sPVR) in patients with repaired Tetralogy of Fallot (rTOF) by Speckle Tracking Echocardiography (STE).Methods: 58 volunteers participated in this study who divided into 3 groups including 22 PVR patients (mean age 18.96±7 year), 16 repaired Tetralogy of Fallot and 20 healthy age match control. For all patients, we performed 2D echocardiography and STE.Results: 2D echocardiography in all groups showed normal LV ejection fraction without a significant statistical difference (64% sPVR, 60% in repaired Tetralogy of Fallot and 62.5% in the control group). However, the mean global longitudinal strains (GLS) of LV were significantly reduced in both sPVR (-17.5±2.5%) and repaired Tetralogy of Fallot (-17.1±4.7%) patients rather than control group (-20.2±0.7%) (P = 0.003). But GLS had no statistically significant difference between repaired Tetralogy of Fallot and sPVR patients (P=0.9). Segmental analysis of longitudinal strain (LS) showed a significant decrease in sPVR patients and repaired Tetralogy of Fallot group in basal anterior, basal septal, basal anterolateral segments, mid-anterior and anterolateral segments. Except for lower LS in the apical-anteroseptal segment, this level was mostly spared in both sPVR and repaired Tetralogy of Fallot patients.Conclusion: LVEF was within normal range after sPVR patients, but the pattern of impaired segmental LS and GLS did not change as compared with rTOF. Surgical PVR in patients with repaired TOF may not have a significant effect on the improvement of LV function assessed by STE. LV damage which happens during surgical correction of TOF may have a permanent deteriorating effect on LV function.
法洛四联症患者肺动脉瓣置换术前后斑点追踪超声心动图:STE能阐明早期左心室功能障碍吗?
目的:TOF是最常见的紫绀型冠心病。我们通过斑点跟踪超声心动图(STE)研究修复法洛四联症(rTOF)患者手术肺动脉瓣置换术(sPVR)后左心室(LV)功能。方法:58名志愿者分为3组,其中PVR患者22例(平均年龄18.96±7岁),修复法洛四联症16例,健康年龄对照组20例。我们对所有患者进行了二维超声心动图和STE检查。结果:2维超声心动图显示各组左室射血分数正常(sPVR为64%,法洛四联症修复组为60%,对照组为62.5%),差异无统计学意义。sPVR组和修复后法洛四联症组左室平均总纵向应变(GLS)(-17.5±2.5%)明显低于对照组(-20.2±0.7%)(P = 0.003)。修复后法洛四联症与sPVR患者GLS差异无统计学意义(P=0.9)。纵应变(LS)节段分析显示sPVR患者和修复后的Fallot四联症组在基底前、基底间隔、基底前外侧节段、中前段和前外侧节段均显著降低。在sPVR和修复后的法洛四联症患者中,除了根尖-前间隔段的下LS外,该水平大部分被保留。结论:sPVR患者术后LVEF在正常范围内,但与rTOF相比,节段性LS和GLS受损的模式没有改变。修复性TOF患者的手术PVR可能对STE评估的左室功能改善没有显著影响。在TOF手术矫正过程中发生的左室损伤可能会对左室功能产生永久性恶化的影响。
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来源期刊
International Cardiovascular Research Journal
International Cardiovascular Research Journal CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
0.40
自引率
50.00%
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