TY - JOUR
T1 - Assessment of myocardial function in pediatric patients with operated tetralogy of Fallot
T2 - Preliminary results with 2D strain echocardiography
AU - Knirsch, Walter
AU - Dodge-Khatami, Ali
AU - Kadner, Alexander
AU - Kretschmar, Oliver
AU - Steiner, Johannes
AU - Böttler, Petra
AU - Kececioglu, Deniz
AU - Harpes, Paul
AU - Valsangiacomo Buechel, Emanuela R.
N1 - Funding Information:
This study was supported by a grant from the University of Zurich, Switzerland. We thank the parents and their children for their participation.
PY - 2008/7
Y1 - 2008/7
N2 - The global myocardial function in patients after repair of tetralogy of Fallot (TOF) can be assessed by cardiovascular magnetic resonance (CMR) and measurement of B-type natriuretic peptides. Two-dimensional echocardiography- derived strain and strain rate (2D strain) facilitate the assessment of regional myocardial function. We evaluated myocardial function in 16 children with residual severe pulmonary valve regurgitation and right ventricular (RV) volume overload after TOF repair before, 1 month after, and 6 months after pulmonary valve replacement (PVR). In 2D strain echocardiography preoperatively, the longitudinal systolic RV strain was reduced (p < 0.05). One month after PVR, longitudinal systolic RV strain decreased further (p < 0.05), while systolic and early diastolic radial left ventricular strain and strain rate increased (each p < 0.05), followed by a return toward preoperative values after 6 months. Six months after PVR, preoperatively elevated RV end-diastolic volume (p < 0.01) assessed by CMR and N-terminal pro-B-type natriuretic peptide (p < 0.05) decreased. In conclusion, the impairment of the regional myocardial after TOF repair and transient changes after PVR can be subtly analyzed by 2D strain echocardiography in addition to the established assessment of myocardial function with CMR and measurement of B-type natriuretic peptides.
AB - The global myocardial function in patients after repair of tetralogy of Fallot (TOF) can be assessed by cardiovascular magnetic resonance (CMR) and measurement of B-type natriuretic peptides. Two-dimensional echocardiography- derived strain and strain rate (2D strain) facilitate the assessment of regional myocardial function. We evaluated myocardial function in 16 children with residual severe pulmonary valve regurgitation and right ventricular (RV) volume overload after TOF repair before, 1 month after, and 6 months after pulmonary valve replacement (PVR). In 2D strain echocardiography preoperatively, the longitudinal systolic RV strain was reduced (p < 0.05). One month after PVR, longitudinal systolic RV strain decreased further (p < 0.05), while systolic and early diastolic radial left ventricular strain and strain rate increased (each p < 0.05), followed by a return toward preoperative values after 6 months. Six months after PVR, preoperatively elevated RV end-diastolic volume (p < 0.01) assessed by CMR and N-terminal pro-B-type natriuretic peptide (p < 0.05) decreased. In conclusion, the impairment of the regional myocardial after TOF repair and transient changes after PVR can be subtly analyzed by 2D strain echocardiography in addition to the established assessment of myocardial function with CMR and measurement of B-type natriuretic peptides.
KW - Echocardiography
KW - Myocardial function
KW - Tetralogy of Fallot
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U2 - 10.1007/s00246-008-9227-y
DO - 10.1007/s00246-008-9227-y
M3 - Article
C2 - 18506501
AN - SCOPUS:46749085820
SN - 0172-0643
VL - 29
SP - 718
EP - 725
JO - Pediatric Cardiology
JF - Pediatric Cardiology
IS - 4
ER -