Shelby Kutty1, Quanliang Shang2, Navya Joseph3, Johannes T Kowallick4, Andreas Schuster4, Michael Steinmetz4, David A Danford3, Phillip Beerbaum5, Samir Sarikouch6. 1. University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, United States. Electronic address: skutty@unmc.edu. 2. University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, United States; Department of Radiology, Central South University, China. 3. University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, United States. 4. Department of Cardiology, Pneumology, and the Institute for Radiology, Georg-August-University Göttingen, Göttingen, Germany. 5. Department of Pediatric Cardiology and Intensive Care, Hanover Medical School, Hanover, Germany. 6. Department of Cardiothoracic Surgery, Hanover Medical School, Hanover, Germany.
Abstract
BACKGROUND: We hypothesized that right atrial (RA) performance is abnormal in repaired tetralogy of Fallot (TOF). METHODS: TOF patients were prospectively enrolled for cardiovascular magnetic resonance (CMR), echocardiography and exercise stress following a standardized 14-center protocol. Peak RA longitudinal strain (RALS) and right ventricular longitudinal strain (RVLS) were measured using CMR feature tracking (FT) and correlated to RA and RV end diastolic volumes (EDVi) and ejection fraction (EF). RESULTS: The cohort had 311 subjects: 171 TOF (94 male, age 18.2±8years) and 140 healthy controls (69 male, 16.4±11years). RAEDVi, RALS, RVEDVi, RVLS, RAEF, and RVEF in TOF were 60.8±17.1ml/m2, 13.6±5.7%, 120.3±30.3ml/m2, 12.3±4.2%, 32.5±9.9% and 51.2±8.4% and differed from respective indices in controls: 51.7±15.7ml/m2, 27±10.1%, 74±19.0ml/m2, 18.5±5.3%, 54±8% and 62.5±5.5% (p<0.001). RAEDVi and RALS correlated with RVLS (p=0.004, <0.001, r=0.2,0.3). RAEDVi was higher in older TOF, while RALS did not increase with age. RAEDVi but not RALS correlated with RV systolic pressure(r=0.2, 0). Neither RAEDVi nor RALS was associated with tricuspid regurgitation grade or peak oxygen uptake (r=0.1, 0). Positive correlation was observed for RVEDVi with RAEDVi (p=0.035, r=0.2) and a trend toward negative correlation with RALS (p=0.09, r=0.1). CONCLUSION: RALS, RAEDVi and RAEF are abnormal in TOF. Reduced RALS indicates decreased RA reservoir function. Because they correlate with other functional RV indices, these abnormalities may represent RA diastolic burden from chronic RV dysfunction in TOF. The young cohort age might explain the absence of RALS correlation to tricuspid regurgitation and peak oxygen uptake.
BACKGROUND: We hypothesized that right atrial (RA) performance is abnormal in repaired tetralogy of Fallot (TOF). METHODS: TOF patients were prospectively enrolled for cardiovascular magnetic resonance (CMR), echocardiography and exercise stress following a standardized 14-center protocol. Peak RA longitudinal strain (RALS) and right ventricular longitudinal strain (RVLS) were measured using CMR feature tracking (FT) and correlated to RA and RV end diastolic volumes (EDVi) and ejection fraction (EF). RESULTS: The cohort had 311 subjects: 171 TOF (94 male, age 18.2±8years) and 140 healthy controls (69 male, 16.4±11years). RAEDVi, RALS, RVEDVi, RVLS, RAEF, and RVEF in TOF were 60.8±17.1ml/m2, 13.6±5.7%, 120.3±30.3ml/m2, 12.3±4.2%, 32.5±9.9% and 51.2±8.4% and differed from respective indices in controls: 51.7±15.7ml/m2, 27±10.1%, 74±19.0ml/m2, 18.5±5.3%, 54±8% and 62.5±5.5% (p<0.001). RAEDVi and RALS correlated with RVLS (p=0.004, <0.001, r=0.2,0.3). RAEDVi was higher in older TOF, while RALS did not increase with age. RAEDVi but not RALS correlated with RV systolic pressure(r=0.2, 0). Neither RAEDVi nor RALS was associated with tricuspid regurgitation grade or peak oxygen uptake (r=0.1, 0). Positive correlation was observed for RVEDVi with RAEDVi (p=0.035, r=0.2) and a trend toward negative correlation with RALS (p=0.09, r=0.1). CONCLUSION: RALS, RAEDVi and RAEF are abnormal in TOF. Reduced RALS indicates decreased RA reservoir function. Because they correlate with other functional RV indices, these abnormalities may represent RA diastolic burden from chronic RV dysfunction in TOF. The young cohort age might explain the absence of RALS correlation to tricuspid regurgitation and peak oxygen uptake.
Authors: Kyle D Hope; Renzo José Carlos Calderón Anyosa; Yan Wang; Andrea E Montero; Tomoyuki Sato; Brian D Hanna; Anirban Banerjee Journal: Pulm Circ Date: 2018-01-08 Impact factor: 3.017
Authors: Michael Steinmetz; Marike Broder; Olga Hösch; Pablo Lamata; Shelby Kutty; Johannes T Kowallick; Wieland Staab; Christian Oliver Ritter; Gerd Hasenfuß; Thomas Paul; Joachim Lotz; Andreas Schuster Journal: Int J Cardiol Date: 2018-02-03 Impact factor: 4.164
Authors: Vien T Truong; Cassady Palmer; Michael Young; Sarah Wolking; Tam N M Ngo; Brandy Sheets; Chelsey Hausfeld; Allison Ornella; Michael D Taylor; Karolina M Zareba; Subha V Raman; Wojciech Mazur Journal: Sci Rep Date: 2020-03-23 Impact factor: 4.379