{"title":"成年法洛四联症修复患者左心房相功能下降：一项病例对照研究。","authors":"Keiya Sato, Ken Takahashi, Yusuke Akatsuka, Hiroyuki Sato, Hirohisa Kago, Azusa Akiya, Satoshi Akimoto, Mayumi Ifuku, Yu Hosono, Sachie Shigemitsu, Kotoko Matsui, Keisuke Nakanishi, Shiori Kawasaki, Toshiaki Shimizu","doi":"10.1186/s12947-025-00355-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although the left atrium (LA) plays a key role in diastolic function, LA dysfunction in patients with repaired tetralogy of Fallot (rTOF) remains unclear. Recently, LA strains assessed using a speckle tracking system have been used as novel sensitive indicators of LA function. Therefore, we aimed to evaluate LA function and investigate changes with age in patients with rTOF using speckle-tracking echocardiography.</p><p><strong>Methods: </strong>We analyzed three age-based subgroups of patients with rTOF (T1, T2, T3) and their corresponding healthy control groups (C1, C2, C3) to assess phasic left atrial function: T1 and C1 (3-9 years [children]), T2 and C2 (10-19 years [adolescents and young adults]), and T3 and C3 (20-44 years [adults]). LA strain was assessed by two-dimensional speckle-tracking echocardiography and defined according to its three distinct phases, with the LA serving as a reservoir during systole, a conduit during early diastole, and a booster pump at the end of diastole. Furthermore, we examined the correlations between LA strains and left ventricular longitudinal strain (LVLS) as well as conventional echocardiographic parameters.</p><p><strong>Results: </strong>LA reservoir and pump strains were lower in the T3 group than in the C3 group (35.5 (30.1/41.3) vs. 42.9 (41.1/48.1), P = 0.010; 8.3 (7.4/10.6) vs. 11.4 (10.7/13.5), P = 0.025, respectively). In the T1 and T2 groups, no significant differences in LA strains were reported. LA functions based on LA volume did not show any difference between rTOF and controls among all age groups. All LA strains only moderately or weakly correlated with LVLS and mitral E/A, but not with left ventricular (LV) lateral e' nor E/e'. Reservoir strain-LVLS (ρ = 0.476, P < 0.001), conduit strain-LVLS (r = 0.382, P < 0.001), pump strain-LVLS (ρ = 0.337, P < 0.001), reservoir strain-E/A (ρ = 0.200, P = 0.026), conduit strain-E/A (ρ = 0.282, P = 0.002), and pump strain-E/A (ρ = -0.209, P = 0.02).</p><p><strong>Conclusions: </strong>LA phasic function decreases in adult patients with rTOF. LA reservoir and pump strains may serve as sensitive indicators of diastolic dysfunction in these patients.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"16"},"PeriodicalIF":1.6000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12291484/pdf/","citationCount":"0","resultStr":"{\"title\":\"Left atrium phasic function decreases in adult patients with repaired tetralogy of fallot: a case-control study.\",\"authors\":\"Keiya Sato, Ken Takahashi, Yusuke Akatsuka, Hiroyuki Sato, Hirohisa Kago, Azusa Akiya, Satoshi Akimoto, Mayumi Ifuku, Yu Hosono, Sachie Shigemitsu, Kotoko Matsui, Keisuke Nakanishi, Shiori Kawasaki, Toshiaki Shimizu\",\"doi\":\"10.1186/s12947-025-00355-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Although the left atrium (LA) plays a key role in diastolic function, LA dysfunction in patients with repaired tetralogy of Fallot (rTOF) remains unclear. Recently, LA strains assessed using a speckle tracking system have been used as novel sensitive indicators of LA function. Therefore, we aimed to evaluate LA function and investigate changes with age in patients with rTOF using speckle-tracking echocardiography.</p><p><strong>Methods: </strong>We analyzed three age-based subgroups of patients with rTOF (T1, T2, T3) and their corresponding healthy control groups (C1, C2, C3) to assess phasic left atrial function: T1 and C1 (3-9 years [children]), T2 and C2 (10-19 years [adolescents and young adults]), and T3 and C3 (20-44 years [adults]). LA strain was assessed by two-dimensional speckle-tracking echocardiography and defined according to its three distinct phases, with the LA serving as a reservoir during systole, a conduit during early diastole, and a booster pump at the end of diastole. Furthermore, we examined the correlations between LA strains and left ventricular longitudinal strain (LVLS) as well as conventional echocardiographic parameters.</p><p><strong>Results: </strong>LA reservoir and pump strains were lower in the T3 group than in the C3 group (35.5 (30.1/41.3) vs. 42.9 (41.1/48.1), P = 0.010; 8.3 (7.4/10.6) vs. 11.4 (10.7/13.5), P = 0.025, respectively). In the T1 and T2 groups, no significant differences in LA strains were reported. LA functions based on LA volume did not show any difference between rTOF and controls among all age groups. All LA strains only moderately or weakly correlated with LVLS and mitral E/A, but not with left ventricular (LV) lateral e' nor E/e'. Reservoir strain-LVLS (ρ = 0.476, P < 0.001), conduit strain-LVLS (r = 0.382, P < 0.001), pump strain-LVLS (ρ = 0.337, P < 0.001), reservoir strain-E/A (ρ = 0.200, P = 0.026), conduit strain-E/A (ρ = 0.282, P = 0.002), and pump strain-E/A (ρ = -0.209, P = 0.02).</p><p><strong>Conclusions: </strong>LA phasic function decreases in adult patients with rTOF. LA reservoir and pump strains may serve as sensitive indicators of diastolic dysfunction in these patients.</p>\",\"PeriodicalId\":9613,\"journal\":{\"name\":\"Cardiovascular Ultrasound\",\"volume\":\"23 1\",\"pages\":\"16\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-07-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12291484/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiovascular Ultrasound\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12947-025-00355-1\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Ultrasound","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12947-025-00355-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Left atrium phasic function decreases in adult patients with repaired tetralogy of fallot: a case-control study.
Background: Although the left atrium (LA) plays a key role in diastolic function, LA dysfunction in patients with repaired tetralogy of Fallot (rTOF) remains unclear. Recently, LA strains assessed using a speckle tracking system have been used as novel sensitive indicators of LA function. Therefore, we aimed to evaluate LA function and investigate changes with age in patients with rTOF using speckle-tracking echocardiography.
Methods: We analyzed three age-based subgroups of patients with rTOF (T1, T2, T3) and their corresponding healthy control groups (C1, C2, C3) to assess phasic left atrial function: T1 and C1 (3-9 years [children]), T2 and C2 (10-19 years [adolescents and young adults]), and T3 and C3 (20-44 years [adults]). LA strain was assessed by two-dimensional speckle-tracking echocardiography and defined according to its three distinct phases, with the LA serving as a reservoir during systole, a conduit during early diastole, and a booster pump at the end of diastole. Furthermore, we examined the correlations between LA strains and left ventricular longitudinal strain (LVLS) as well as conventional echocardiographic parameters.
Results: LA reservoir and pump strains were lower in the T3 group than in the C3 group (35.5 (30.1/41.3) vs. 42.9 (41.1/48.1), P = 0.010; 8.3 (7.4/10.6) vs. 11.4 (10.7/13.5), P = 0.025, respectively). In the T1 and T2 groups, no significant differences in LA strains were reported. LA functions based on LA volume did not show any difference between rTOF and controls among all age groups. All LA strains only moderately or weakly correlated with LVLS and mitral E/A, but not with left ventricular (LV) lateral e' nor E/e'. Reservoir strain-LVLS (ρ = 0.476, P < 0.001), conduit strain-LVLS (r = 0.382, P < 0.001), pump strain-LVLS (ρ = 0.337, P < 0.001), reservoir strain-E/A (ρ = 0.200, P = 0.026), conduit strain-E/A (ρ = 0.282, P = 0.002), and pump strain-E/A (ρ = -0.209, P = 0.02).
Conclusions: LA phasic function decreases in adult patients with rTOF. LA reservoir and pump strains may serve as sensitive indicators of diastolic dysfunction in these patients.
期刊介绍：
Cardiovascular Ultrasound is an online journal, publishing peer-reviewed: original research; authoritative reviews; case reports on challenging and/or unusual diagnostic aspects; and expert opinions on new techniques and technologies. We are particularly interested in articles that include relevant images or video files, which provide an additional dimension to published articles and enhance understanding.
As an open access journal, Cardiovascular Ultrasound ensures high visibility for authors in addition to providing an up-to-date and freely available resource for the community. The journal welcomes discussion, and provides a forum for publishing opinion and debate ranging from biology to engineering to clinical echocardiography, with both speed and versatility.
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