Key result
Patients with repaired tetralogy of Fallot exhibited significantly smaller left ventricular torsion compared to normal controls (P<0.01), alongside decreased basal and septal strain.
Why the study?
Does speckle tracking imaging detect abnormal left ventricular torsion and strain in asymptomatic patients with repaired tetralogy of Fallot compared to normal controls?
Case-Control (n=58)
Does speckle tracking imaging detect abnormal left ventricular torsion and strain in asymptomatic patients with repaired tetralogy of Fallot compared to normal controls?
Speckle tracking imaging reveals abnormal left ventricular torsion and strain in asymptomatic patients with repaired tetralogy of Fallot, suggesting its utility for detecting early LV dysfunction.
Answers are grounded in this paper and cite their sources.
Speckle tracking may identify subclinical LV dysfunction in repaired tetralogy of Fallot; hypothesis-generating and requires prospective validation.
BACKGROUND: In patients with tetralogy of Fallot (TOF), left ventricular (LV) dysfunction is an important factor associated with poor clinical outcome. OBJECTIVE: The purpose of this study was to investigate the torsion and multidirectional strain of the LV in patients with TOF. METHODS: Echocardiographic images were prospectively acquired in 29 patients who underwent TOF repair (age range, 5-25 years) and in 29 normal controls. Torsion and circumferential and longitudinal strain of the LV were assessed using speckle tracking imaging. RESULTS: The torsion in patients was smaller compared to that in the controls due to small apical rotation and/or inverse basal rotation (P < 0.01). Torsion and untwisting rates decreased with increasing age (R = 0.37, P < 0.05). Basal circumferential strain and strain rate (SR) at systole and diastole decreased with age (R = 0.58; R = 0.57; R = 0.57, all P < 0.001) and were smaller in patients compared to those in the controls (all P < 0.01). Septal longitudinal strain and SR at systole and diastole decreased with age (R = 0.52; R = 0.62; R = 0.71, all P < 0.001) and were smaller than those of the controls (P < 0.01), although lateral longitudinal strain and SR were relatively maintained. CONCLUSION: Abnormal torsion and strain pattern of the LV were observed in patients without symptoms of cardiac failure. Assessment of torsion and strain is a very sensitive tool to detect the early deterioration of LV function in patients with TOF.
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Takayasu et al. (2011) conducted a case-control in Repaired Tetralogy of Fallot (n=58). Repaired tetralogy of Fallot vs. Normal controls was evaluated on Left ventricular torsion and multidirectional strain (p=<0.01). Patients with repaired tetralogy of Fallot exhibited significantly smaller left ventricular torsion compared to normal controls (P<0.01), alongside decreased basal and septal strain.
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