BACKGROUND: Right ventricular (RV) volume overload results in RV dilatation in patients with atrial septal defect (ASD) and after tetralogy of Fallot (ToF) repair with pulmonary regurgitation. AIM: Study the differential effects of chronic RV volume loading on regional and global RV deformation in patients with ASD and after TOF repair. METHODS: We studied 85 subjects: 50 patients after ToF repair, 15 patients with unrepaired ASD and 20 age-matched controls. The ToF patients and controls underwent an echocardiography at the time of a clinically indicated MRI. The ASD patients had a routine echocardiogram including RV volume calculations. Longitudinal deformation was analyzed using 2-D speckle tracking echocardiography. RESULTS: RV free wall global and segmental longitudinal deformation was significantly lower in ToF patients compared with ASD and controls (p<0.001). In ToF patients, there was a progressive decrease in strain values from base to apex (p<0.001), while in the ASD group there was a progressive increase (p=0.04). We found strong negative correlations between RV size and RV longitudinal strain measurements, strongest with RV length (R=0.72). When corrected for RV size, all ASD patients had normal or higher deformation values while half of the TOF patients had significantly lower values. CONCLUSION: Global and regional myocardial RV deformation is differently affected by chronic volume loading in ASD versus TOF patients, especially regarding the apical function. This suggests a different adaptation mechanism in both diseases. Our data also suggest that strain measurements are strongly influenced by ventricular size, which should be taken into consideration when interpreting strain values.
BACKGROUND: Right ventricular (RV) volume overload results in RV dilatation in patients with atrial septal defect (ASD) and after tetralogy of Fallot (ToF) repair with pulmonary regurgitation. AIM: Study the differential effects of chronic RV volume loading on regional and global RV deformation in patients with ASD and after TOF repair. METHODS: We studied 85 subjects: 50 patients after ToF repair, 15 patients with unrepaired ASD and 20 age-matched controls. The ToF patients and controls underwent an echocardiography at the time of a clinically indicated MRI. The ASDpatients had a routine echocardiogram including RV volume calculations. Longitudinal deformation was analyzed using 2-D speckle tracking echocardiography. RESULTS: RV free wall global and segmental longitudinal deformation was significantly lower in ToF patients compared with ASD and controls (p<0.001). In ToF patients, there was a progressive decrease in strain values from base to apex (p<0.001), while in the ASD group there was a progressive increase (p=0.04). We found strong negative correlations between RV size and RV longitudinal strain measurements, strongest with RV length (R=0.72). When corrected for RV size, all ASDpatients had normal or higher deformation values while half of the TOF patients had significantly lower values. CONCLUSION: Global and regional myocardial RV deformation is differently affected by chronic volume loading in ASD versus TOF patients, especially regarding the apical function. This suggests a different adaptation mechanism in both diseases. Our data also suggest that strain measurements are strongly influenced by ventricular size, which should be taken into consideration when interpreting strain values.
Authors: Philip Thaler Levy; Mark R Holland; Timothy J Sekarski; Aaron Hamvas; Gautam K Singh Journal: J Am Soc Echocardiogr Date: 2013-07-20 Impact factor: 5.251
Authors: Philip T Levy; Aliza Machefsky; Aura A Sanchez; Meghna D Patel; Sarah Rogal; Susan Fowler; Lauren Yaeger; Angela Hardi; Mark R Holland; Aaron Hamvas; Gautam K Singh Journal: J Am Soc Echocardiogr Date: 2015-12-30 Impact factor: 5.251
Authors: D Yim; L Mertens; C T Morgan; M K Friedberg; L Grosse-Wortmann; A Dragulescu Journal: Int J Cardiovasc Imaging Date: 2016-12-22 Impact factor: 2.357
Authors: Michael Huntgeburth; Ingo Germund; Lianne M Geerdink; Narayanswami Sreeram; Floris E A Udink Ten Cate Journal: Cardiovasc Diagn Ther Date: 2019-10
Authors: Philip T Levy; Aura A Sanchez Mejia; Aliza Machefsky; Susan Fowler; Mark R Holland; Gautam K Singh Journal: J Am Soc Echocardiogr Date: 2014-02-26 Impact factor: 5.251
Authors: C Wohlmuth; C J Kellenberger; E M Voser; B E Burkhardt; E R Valsangiacomo Buechel Journal: Pediatr Cardiol Date: 2014-08-03 Impact factor: 1.655
Authors: Daniel S Knight; Johannes P Schwaiger; Sylvia Krupickova; Joseph Davar; Vivek Muthurangu; J Gerry Coghlan Journal: J Am Soc Echocardiogr Date: 2015-04-06 Impact factor: 5.251