Key result
Patients with single ventricle physiology after Fontan completion had significantly higher atrial fraction (39.2% vs 32.7% for right ventricle) compared with normal controls.
Why the study?
Do patients with single ventricle physiology after Fontan completion have different echocardiographic atrial properties compared to normal controls?
Observational
Do patients with single ventricle physiology after Fontan completion have different echocardiographic atrial properties compared to normal controls?
Patients with single ventricle physiology after Fontan completion exhibit significant differences in echocardiographic atrial properties, including higher atrial fraction and lower E/A ratio, compared to normal controls.
May inform atrial surveillance in Fontan patients; leaves open prognostic value and therapeutic implications.
INTRODUCTION: Atrial function is increasingly being recognized as a significant factor in overall cardiac function in adults. Limited studies evaluating atrial properties exist in the pediatric congenital heart disease population. The goal of this study was to evaluate atrial properties in patients with single ventricle physiology after Fontan completion and compare these values with normal control patients. METHODS: Echocardiograms were performed in patients with single ventricular physiology and in control patients. Tissue Doppler and blood flow measurements were obtained. Atrial fraction and atrial electromechanical values were calculated. Differences were assessed with one-way analysis of variance. Post hoc comparisons were performed with Tukey adjustment. P < .05 was considered significant. RESULTS: No significant difference was present in age or heart rate between single ventricle and control patients. The single right ventricle tricuspid valve A wave (52.6 ± 14.5 vs. 36.7 ± 10.4 cm/s) and atrial fraction (39.2 ± 6.2 vs. 32.7 ± 7.7%) were significantly higher, and the E/A ratio (1.4 + 0.3 vs. 1.8 + 0.4), tricuspid valve E/A velocity-time integral (1.6 + 0.4 vs. 2.2 + 0.7 cm), and late diastolic annular value (5.3 + 1.5 vs. 8.7 + 1.4 cm/s) were significantly lower compared with the controls. The single left ventricle late diastolic annular velocity (4.2 + 1.0 vs. 6.7 + 1.3 cm/s) was significantly lower and atrial fraction was significantly higher compared with the controls (37.7 ± 12.5 vs. 29.8 ± 4.3%). There were no significant differences in atrial electromechanical measurements between groups, but the single right ventricle patients tended to have increased atrial dyssynchrony compared with controls. CONCLUSIONS: Patients with single ventricle physiology after Fontan completion have differences in atrial properties when compared with normal controls. These differences may have important implications in their long-term outcomes. Further studies are necessary to determine the clinical significance of these findings.
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Stines et al. (2011) conducted an observational in Single ventricle physiology. Single ventricle physiology after Fontan completion vs. Normal controls was evaluated on Echocardiographic atrial properties including atrial fraction and electromechanical values. Patients with single ventricle physiology after Fontan completion had significantly higher atrial fraction (39.2% vs 32.7% for right ventricle) compared with normal controls.
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