Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-17T17:12:32.720Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessment of inter-atrial, inter-ventricular, and atrio-ventricular interactions in tetralogy of Fallot patients after surgical correction. Insights from two-dimensional speckle tracking and three-dimensional echocardiography

Published online by Cambridge University Press:  23 October 2014

Mohamed Abd El Rahman ,
Tanja Raedle-Hurst ,
Axel Rentzsch ,
Hans-Joachim Schäfers  and
Hashim Abdul-Khaliq
Mohamed Abd El Rahman
Affiliation:
Department of Pediatric Cardiology, Saarland University Hospital, Homburg, Germany Department of Pediatrics and Pediatric Cardiology, Cairo University, Egypt
Tanja Raedle-Hurst
Affiliation:
Department of Pediatric Cardiology, Saarland University Hospital, Homburg, Germany
Axel Rentzsch
Affiliation:
Department of Pediatric Cardiology, Saarland University Hospital, Homburg, Germany
Hans-Joachim Schäfers
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg/Saar, Germany
Hashim Abdul-Khaliq*
Affiliation:
Department of Pediatric Cardiology, Saarland University Hospital, Homburg, Germany
*
Correspondence to: Prof. Dr H. Abdul-Khaliq, MD, PhD, Department of Paediatric Cardiology, Saarland University Hospital, Kirrberger Straße, 66421 Homburg/Saar, Germany. Tel: +496 841 162 8306; Fax: +496 841 162 8330; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: We aimed to assess biatrial size and function, interactions on atrial and ventricular levels, and atrio-ventricular coupling in patients after tetralogy of Fallot repair. Methods: A total of 34 patients with a mean age of 20.9±9 years, and 35 healthy controls, underwent two-dimensional speckle tracking echocardiography for ventricular and atrial strain measurements and real-time three-dimensional echocardiography to assess ventricular and atrial volumes. Results: When compared with controls, tetralogy of Fallot patients had significantly reduced right atrial peak atrial longitudinal strain (p<0.01), right atrial peak atrial contraction strain (p<0.01), right atrial ejection fraction (p<0.01), left atrial peak atrial longitudinal strain (p<0.01), left atrial peak atrial contraction strain (p<0.05), and left atrial ejection fraction (p<0.01). In the tetralogy of Fallot group, left ventricular ejection fraction was negatively related to the right ventricular end-systolic volume normalised to body surface area (r=−0.62, p<0.01). An association was found in patients between the right atrial peak longitudinal strain and mean right ventricular strain (r=0.64, p<0.01). In patients, the left atrial peak longitudinal strain correlated negatively with right atrial end-diastolic volume normalised to body surface area (r=−0.67, p<0.01), whereas the left atrial ejection fraction correlated weakly with left ventricular ejection fraction (r=0.41, p<0.05). Conclusions: In asymptomatic tetralogy of Fallot patients, biatrial dysfunction exists and can be quantified via two-dimensional speckle tracking echocardiography as well as real-time three-dimensional echocardiography. Different forms of interactions on atrial and ventricular levels are evident among such cohorts.

Keywords

Tetralogy of Fallotatrial functiontwo-dimensional echocardiographyreal-time three-dimensional echocardiography
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 7 , October 2015 , pp. 1254 - 1262
Copyright
© Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Bashore, TM. Adult congenital heart disease: right ventricular outflow tract lesions. Circulation 2007; 115: 1933–1947.CrossRefGoogle ScholarPubMed
2. Murphy, JG, Gersh, BJ, Mair, DD, et al. Long-term outcome in patients undergoing surgical repair of tetralogy of Fallot. N Engl J Med 1993; 329: 593–599.CrossRefGoogle ScholarPubMed
3. Abd El Rahman, MY, Abdul-Khaliq, H, Vogel, M, et al. Value of the new Doppler-derived myocardial performance index for the evaluation of right and left ventricular function following repair of tetralogy of fallot. Pediatr Cardiol 2002; 23: 502–507.CrossRefGoogle ScholarPubMed
4. Ghai, A, Silversides, C, Harris, L, Webb, GD, Siu, SC, Therrien, J. Left ventricular dysfunction is a risk factor for sudden cardiac death in adults late after repair of tetralogy of Fallot. J Am Coll Cardiol 2002; 40: 1675–1680.CrossRefGoogle ScholarPubMed
5. Piotrowski, G, Goch, A, Wlazlowski, R, Gawor, Z, Goch, JH. Non-invasive methods of atrial function evaluation in heart diseases. Med Sci Monit 2000; 6: 827–839.Google ScholarPubMed
6. Prioli, A, Marino, P, Lanzoni, L, Zardini, P. Increasing degrees of left ventricular filling impairment modulate left atrial function in humans. Am J Cardiol 1998; 82: 756–761.CrossRefGoogle ScholarPubMed
7. Kono, T, Sabbah, HN, Rosman, H, Alam, M, Stein, PD, Goldstein, S. Left atrial contribution to ventricular filling during the course of evolving heart failure. Circulation 1992; 86: 1317–1322.CrossRefGoogle ScholarPubMed
8. Hui, W, Abd El Rahman, MY, Dsebissowa, F, et al. Quantitative analysis of right atrial performance after surgical repair of tetralogy of Fallot. Cardiol Young 2004; 14: 520–526.CrossRefGoogle ScholarPubMed
9. Riesenkampff, E, Mengelkamp, L, Mueller, M, et al. Integrated analysis of atrioventricular interactions in tetralogy of Fallot. Am J Physiol Heart Circ Physiol 2010; 299: H364–H371.CrossRefGoogle ScholarPubMed
10. Luijnenburg, SE, Peters, RE, van der Geest, RJ, et al. Abnormal right atrial and right ventricular diastolic function relate to impaired clinical condition in patients operated for tetralogy of Fallot. Int J Cardiol 2013; 167: 833–839.CrossRefGoogle ScholarPubMed
11. Aune, E, Baekkevar, M, Roislien, J, Rodevand, O, Otterstad, JE. Normal reference ranges for left and right atrial volume indexes and ejection fractions obtained with real-time three-dimensional echocardiography. Eur J Echocardiogr 2009; 10: 738–744.CrossRefGoogle ScholarPubMed
12. Cameli, M, Lisi, M, Focardi, M, et al. Left atrial deformation analysis by speckle tracking echocardiography for prediction of cardiovascular outcomes. Am J Cardiol 2004; 110: 264–269.CrossRefGoogle Scholar
13. Mueller, M, Rentzsch, A, Hoetzer, K, et al. Assessment of interventricular and right-intraventricular dyssynchrony in patients with surgically repaired tetralogy of Fallot by two-dimensional speckle tracking. Eur J Echocardiogr, 11: 786–792.Google Scholar
14. Hatle, L. Noninvasive assessment of valve lesions with Doppler ultrasound. Herz 1984; 9: 213–221.Google ScholarPubMed
15. Gatzoulis, MA, Clark, AL, Cullen, S, Newman, CG, Redington, AN. Right ventricular diastolic function 15 to 35 years after repair of tetralogy of Fallot. Restrictive physiology predicts superior exercise performance. Circulation 1995; 91: 1775–1781.CrossRefGoogle ScholarPubMed
16. Cameli, M, Lisi, M, Righini, FM, Mondillo, S. Novel echocardiographic techniques to assess left atrial size, anatomy and function. Cardiovasc Ultrasound 2012; 10: 4.CrossRefGoogle Scholar
17. Seguela, PE, Hascoet, S, Brierre, G, Bongard, V, Acar, P. Feasibility of three-dimensional transthoracic echocardiography to evaluate right ventricular volumes in children and comparison to left ventricular values. Echocardiography 2011; 29: 492–501.CrossRefGoogle ScholarPubMed
18. Bland, JM, Altman, DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–310.CrossRefGoogle ScholarPubMed
19. Hausdorf, G, Hinrichs, C, Nienaber, CA, Schark, C, Keck, EW. Left ventricular contractile state after surgical correction of tetralogy of Fallot: risk factors for late left ventricular dysfunction. Pediatr Cardiol 1990; 11: 61–68.CrossRefGoogle ScholarPubMed
20. Krymsky, LD. Pathologic anatomy of congenital heart disease. Circulation 1965; 32: 814–827.CrossRefGoogle ScholarPubMed
21. Lange, PE, Onnasch, DG, Bernhard, A, Heintzen, PH. Left and right ventricular adaptation to right ventricular overload before and after surgical repair of tetralogy of Fallot. Am J Cardiol 1982; 50: 786–794.CrossRefGoogle ScholarPubMed
22. Abd El Rahman, MY, Hui, W, Dsebissowa, F, et al. Quantitative analysis of paradoxical interventricular septal motion following corrective surgery of tetralogy of Fallot. Pediatr Cardiol 2005; 26: 379–384.CrossRefGoogle ScholarPubMed
23. Bazaz, R, Edelman, K, Gulyasy, B, Lopez-Candales, A. Evidence of robust coupling of atrioventricular mechanical function of the right side of the heart: insights from M-mode analysis of annular motion. Echocardiography 2008; 25: 557–561.CrossRefGoogle ScholarPubMed
24. Abd El Rahman, MY, Hui, W, Yigitbasi, M, et al. Detection of left ventricular asynchrony in patients with right bundle branch block after repair of tetralogy of Fallot using tissue-Doppler imaging-derived strain. J Am Coll Cardiol 2005; 45: 915–921.CrossRefGoogle ScholarPubMed
25. Lam, YY, Kaya, MG, Goktekin, O, Gatzoulis, MA, Li, W, Henein, MY. Restrictive right ventricular physiology: its presence and symptomatic contribution in patients with pulmonary valvular stenosis. J Am Coll Cardiol 2007; 50: 1491–1497.CrossRefGoogle ScholarPubMed