Key result
Basal isovolumic acceleration was significantly lower in univentricular hearts with a dominant right (1.0 m/s2) or left ventricle (0.8 m/s2) compared to normal hearts (1.9 m/s2; p<0.05).
Why the study?
Does tissue Doppler-derived isovolumic acceleration reveal differences in myocardial contractility between univentricular hearts and structurally normal hearts during atrial pacing?
Observational
No
Does tissue Doppler-derived isovolumic acceleration reveal differences in myocardial contractility between univentricular hearts and structurally normal hearts during atrial pacing?
Tissue Doppler-derived isovolumic acceleration demonstrates that basal contractility is depressed in univentricular hearts compared to normal left ventricles, with no significant difference between dominant right and left ventricles over physiological heart rates.
Indicates depressed basal contractility in univentricular hearts; leaves open IVA's role in monitoring single-ventricle function.
OBJECTIVE: To describe the first clinical application of a novel tissue Doppler derived index of contractility, isovolumic acceleration (IVA), in the assessment of the ventricular myocardial force-frequency relation (FFR) in the univentricular heart (UVH). DESIGN: Prospective study. SETTING: Tertiary referral centre. INTERVENTIONS: Non-invasive assessment of the myocardial FFR by tissue Doppler echocardiography during atrial pacing. RESULTS: IVA was used to measure the FFR of the systemic ventricle in patients with structurally normal hearts and in patients with UVHs. Basal IVA of the normal hearts (mean (SD) 1.9 (0.3) m/s2) was significantly greater than that of UVHs in patients with a dominant right ventricle (RV) (1.0 (0.3) m/s2) or left ventricle (LV) (0.8 (0.7) m/s2; p < 0.05 for both). Neither the absolute nor percentage change from basal to peak values of IVA with pacing differed between the three groups. Peak force developed by the normal LV was significantly greater than that of the UVH, dominant LV group but not different from that of the UVH, dominant RV group. CONCLUSION: Contractility at basal heart rate is depressed in patients with UVH compared with the normal LV. Analysis of ventricular FFRs exposes further differences in myocardial contractility. There is no evidence that contractile function of the dominant RV is inferior to that of the dominant LV over a physiological range of heart rates.
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Michael M.H. Cheung (2005) conducted an observational in Congenital heart disease (univentricular heart). Tissue Doppler echocardiography during atrial pacing vs. Structurally normal hearts was evaluated on Basal isovolumic acceleration (IVA) (p=< 0.05). Basal isovolumic acceleration was significantly lower in univentricular hearts with a dominant right (1.0 m/s2) or left ventricle (0.8 m/s2) compared to normal hearts (1.9 m/s2; p<0.05).
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