Mechanisms of Left Ventricular Dysfunction Assessed by Layer-Specific Strain Analysis in Patients With Repaired Tetralogy of Fallot

179 subjects, comprising 66 patients with repaired tetralogy of Fallot (rTOF) (mean age 16.3±9.3 years, divided into 3 age groups: 4-10 years, 11-20 years, 21-43 years) and 113 healthy controls of similar age (mean age 17.2±9.3 years). Excluded: residual intracardiac shunts, known ventricular arrhythmias, and implanted pacemakers.

113 healthy controls of similar age with no history of cardiovascular disease, normal sinus rhythm on ECG, and normal findings on echocardiography

Left ventricular layer-specific longitudinal strain (LS) and circumferential strain (CS) of 3 myocardial layers (endocardial, midmyocardial, and epicardial) measured by 2D speckle-tracking echocardiographysurrogate