Key result
Dominant LV morphology and prior cavopulmonary shunts link to better STE strain in impaired single ventricles.
Why the study?
Functional single ventricle encompasses heterogeneous anomalies, and the impact of ventricular morphology on myocardial deformation evaluated by speckle-tracking echocardiography required determination.
Does two-dimensional speckle-tracking echocardiography detect subtle ventricular dysfunction compared to standard 2D echocardiography in pediatric patients with single ventricle?
Observational (n=47)
No
Does two-dimensional speckle-tracking echocardiography detect subtle ventricular dysfunction compared to standard 2D echocardiography in pediatric patients with single ventricle?
Speckle-tracking echocardiography can unmask subtle ventricular dysfunction in pediatric patients with single ventricle who appear to have normal ejection fraction by standard 2D echocardiography.
May support strain for subtype risk assessment in single ventricle patients; leaves open need for prospective outcome studies.
Introduction: Functional single ventricle represent a heterogeneous group of anomalies sharing a common feature which is a functional single cardiac chamber. (1) In different series of congenital heart disease patients, cases of UVH represent about 1–2% of total congenital heart diseases. (2) Two-dimensional speckle-tracking echocardiography has recently emerged as a novel technique for objective and quantitative evaluation of global and regional myocardial function. Objectives: To determine impact of ventricular morphology on myocardial deformation in patients with single ventricle. Patients and Methods: The study included 47 patients with functional single ventricle whether they underwent cavopulmonary anastomosis or not. All patients were referred for elective cardiac catheterization or follow up echocardiography in Ain Shams university hospitals, Cardiology department, from November 2017 to July 2018. All patients underwent full echocardiographic assessment including assessment of the dominant ventricular function by STE. Results: The study included 47 patients, 30 males (63.8%) and 17 females (36.2%). Their age ranged between 6-12 years, with mean age of 8.22 ± 1.94. The morphology of the dominant ventricle determined ventricular function by both 2D parameters and STE. Patients with a dominant LV had higher strain values. Patients who underwent a cavopulmonary shunt also had better ventricular functions. All patients included in the study showed impaired dominant ventricular function by STE even those who had normal EF by standard 2D TTE suggesting that subtle ventricular dysfunction in patients with single ventricle can be unmasked by STE.
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Ezzeldin et al. (2019) conducted an observational in Functional single ventricle (n=47). Dominant left ventricular morphology vs. Other dominant ventricular morphologies was evaluated on Dominant ventricular function assessed by speckle-tracking echocardiography (STE). Dominant left ventricular morphology and prior cavopulmonary shunt were associated with better strain values, though all single ventricle patients showed impaired function by STE.
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