Key result
Repaired pulmonary stenosis with preserved RVEF was associated with increased right ventricular global circumferential strain compared to healthy controls.
Why the study?
Right ventricular dilation, dysfunction, and abnormal right and left ventricular interactions are common after pulmonary stenosis intervention, but ventricular strain and remodeling remained to be analyzed in repaired pulmonary stenosis patients with preserved RVEF.
Do patients with repaired pulmonary stenosis and preserved RVEF exhibit abnormal ventricular strain, remodeling, and ventricular interactions compared to healthy children?
Cross-Sectional (n=44)
Do patients with repaired pulmonary stenosis and preserved RVEF exhibit abnormal ventricular strain, remodeling, and ventricular interactions compared to healthy children?
Cardiac magnetic resonance reveals that children with repaired pulmonary stenosis and preserved RVEF already exhibit compensated increased RV strain, RV remodeling, and adverse ventricular interactions that may impair LV function.
Answers are grounded in this paper and cite their sources.
Subclinical RV strain changes and adverse interactions occur in preserved-RVEF rPS; hypothesis-generating for CMR strain monitoring in congenital disease.
Background Right ventricular dilation and dysfunction is a common long‐term complication in patients with repaired pulmonary stenosis (rPS). Additionally, abnormal right and left ventricular interactions have been reported in right‐sided heart defect after intervention, including in pulmonary stenosis. Purpose To analyze ventricular strain, remodeling, and left and right ventricular interactions in rPS patients with preserved right ventricular ejection fraction (RVEF) compared with healthy children using cardiac magnetic resonance. Study Type A cross‐sectional study. Population In all, 34 rPS patients and 10 healthy children volunteers (controls). Field Strength/Sequence 3.0T/2D balanced steady‐state free precession (2D b‐SSFP) cine, late gadolinium enhancement (LGE), and 2D phase contrast (2D‐PC). Assessment Pulmonary regurgitation (PR) fractions of the main pulmonary artery, biventricular volumes, masses, function, and cardiac strain. Statistical Tests Mann–Whitney U‐test, t‐test, Pearson correlation coefficients, Spearman's correlation coefficients, and intraclass correlation coefficients analysis were performed. Results For group analysis, the right ventricular (RV) global circumferential strain and radial strain were significantly increased in patients when compared with controls (−13.57 ± 2.69 vs. −5.91 ± 3.16, P < 0.001; 25.31 ± 8.12 vs. 9.87 ± 5.32, P < 0.001, respectively). The fraction of PR displayed moderate correlation with right ventricular end‐diastolic volume index (RVEDVi) (r = 0.452, P = 0.022). RVEDVi and mass index were larger in patients vs. control (104.92 ± 27.46 vs. 85.15 ± 11.98, P = 0.016; 18.28 ± 4.95g/m2 vs. 11.67 ± 2.14 g/m2, P < 0.001, respectively). Patients presented with preserved left ventricular ejection function, but was lower than healthy controls (60.89% ± 4.89% vs. 65.95% ± 4.56%, P = 0.006). Regional circumferential strain of segment 3 of left ventricle (LV) were significantly decreased in patients (−7.79 ± 6.52 vs. −13.56 ± 3.22, P = 0.003). Data Conclusion Compensated increased RV strain, myocardial remodeling of RV, and adverse right and left ventricular interactions occur in rPS patients with preserved RVEF. The decreased interventricular septum strain may lead to impaired LV function due to RV dilation as a result of PR. Level of Evidence: 3 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2020;52:129–138.
No takes yet. Share an insight, caveat, or question.
Wang et al. (2020) conducted a cross-sectional in Repaired pulmonary stenosis with preserved right ventricular ejection fraction (n=44). Repaired pulmonary stenosis vs. Healthy children was evaluated on Right ventricular global circumferential strain (p=<0.001). Repaired pulmonary stenosis with preserved RVEF was associated with increased right ventricular global circumferential strain compared to healthy controls.
Synapse has enriched 10 related papers. Consider them for comparative context: