Key result
Asymptomatic children with repaired tetralogy of Fallot had impaired RV and LV strain compared to controls, with RV and LV global longitudinal strain rate correlating with follow-up.
Why the study?
Does two-dimensional speckle tracking echocardiography detect early impairment of ventricular function in asymptomatic children with repaired tetralogy of Fallot compared to healthy controls?
Observational (n=91)
Does two-dimensional speckle tracking echocardiography detect early impairment of ventricular function in asymptomatic children with repaired tetralogy of Fallot compared to healthy controls?
Two-dimensional speckle tracking echocardiography can identify early impairment of right and left ventricular systolic function in asymptomatic postoperative tetralogy of Fallot patients with preserved ejection fraction.
Answers are grounded in this paper and cite their sources.
STE may detect subclinical biventricular dysfunction in repaired TOF despite preserved EF; leaves open its prognostic or management role.
BACKGROUND: Early detection of right ventricular (RV) and left ventricular (LV) dysfunction in patients with repaired tetralogy of Fallot (TOF) is essential because dysfunction is correlated with a poor clinical outcome. The aim of this study was to assess RV and LV function in asymptomatic children with repaired TOF by two-dimensional ultrasound speckle tracking echocardiography (STE). METHODS: Fifty-six asymptomatic children with a preserved biventricular ejection fraction (EF) after repair of TOF and 35 healthy control subjects were studied. RV and LV strain and strain rate were measured by STE. RVEF and pulmonary regurgitation (PR) were assessed using cardiac magnetic resonance imaging. RESULTS: Compared with the control subjects, RV regional longitudinal strain and strain rate and global longitudinal strain (GLS) and strain rate (GLSR) were impaired in children with repaired TOF. Likewise, LV circumferential and radial strain and strain rate were reduced in patients with TOF. In contrast, longitudinal strain and strain rate did not differ between the groups. RV and LV GLSR were correlated with postoperative follow-up period (r1 = -0.44; r2 = -0.48). RV GLS and GLSR were associated with RVEF (r1 = 0.64; r2 = 0.60) and PR (r1 = -0.48; r2 = -0.49). LV circumferential strain rate was related to PR (r = -0.45). CONCLUSIONS: STE can identify abnormalities that may represent early impairment of RV and LV systolic function in postoperative TOF patients with a preserved EF. PR is associated with decreased biventricular performance in repaired patients. STE-derived strain and strain rate may be useful indices for detecting the early deterioration of biventricular performance in patients with TOF.
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Li et al. (2014) conducted an observational in Repaired tetralogy of Fallot (n=91). Repaired tetralogy of Fallot vs. Healthy control subjects was evaluated on Right and left ventricular strain and strain rate by two-dimensional speckle tracking echocardiography. Asymptomatic children with repaired tetralogy of Fallot had impaired RV and LV strain compared to controls, with RV and LV global longitudinal strain rate correlating with follow-up.
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