Abnormal left atrial compliance is associated with history of life-threatening arrhythmia in corrected tetralogy of Fallot

Introduction

This study examined the left atrial (LA) function and compliance using two-dimensional (2D) strain analysis in adult patients with corrected tetralogy of Fallot (c-ToF), as well as relationships between LA function and patient characteristics, especially history of life-threatening arrhythmia (h-LTA).

Method

Fifty-one patients (34 males, age: 39 ± 15 years; h-LTA: n = 13) with c-ToF were included in this retrospective monocenter study. Besides a 2D standard echocardiography examination, 2D strain imaging was performed to assess left ventricular (LV) and LA functions including peak-positive LA strain (LAS – reservoir function) and LA compliance [defined as the ratio LAS/(E/Ea)].

Results

Patients with h-LTA were older and exhibited a longer QRS duration. LV ejection fraction, LAS and LA compliance were significantly lower in the group of patients with h-LTA. Indexed LA and RA volumes, RV end-diastolic area and RV fractional area change were significantly higher in the h-LTA group. LA compliance was the best echocardiographic predictor for h-LTA (AUC: 0.839; P < 0.001). Moderate inverted correlations were found between LA compliance and age and either QRS duration. Among the echocardiographic parameters, LA compliance was moderately inversely correlated with RV end-diastolic area (r = −0.40, P = 0.01).

Conclusion

We documented abnormal LAS and LA compliance values in adults after c-ToF. Further study is needed to determine how best to incorporate LA strain, particularly LA compliance into multi-parametric predictive models for LTA in c-ToF.