Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T23:44:32.616Z Has data issue: false hasContentIssue false
  • English
  • Français

Quantitative analysis of right atrial performance after surgical repair of tetralogy of Fallot

Published online by Cambridge University Press:  21 January 2005

Wei Hui ,
Mohamed Y. Abd El Rahman ,
Fatima Dsebissowa ,
Axel Rentzsch ,
Matthias Gutberlet ,
Vladimir Alexi-Meskishvili ,
Roland Hetzer ,
Peter E. Lange  and
Hashim Abdul-Khaliq
Wei Hui
Affiliation:
Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University, Berlin, Germany
Mohamed Y. Abd El Rahman
Affiliation:
Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University, Berlin, Germany
Fatima Dsebissowa
Affiliation:
Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University, Berlin, Germany
Axel Rentzsch
Affiliation:
Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University, Berlin, Germany
Matthias Gutberlet
Affiliation:
Department of Radiology and Nuclear Medicine, University Hospital Charité, Humboldt University, Berlin, Germany
Vladimir Alexi-Meskishvili
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany
Roland Hetzer
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany
Peter E. Lange
Affiliation:
Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University, Berlin, Germany
Hashim Abdul-Khaliq
Affiliation:
Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University, Berlin, Germany
Get access Rights & Permissions [Opens in a new window]

Abstract

We aimed to assess the right atrial performance in patients after surgical correction of tetralogy of Fallot, and to clarify the relationship between the pump function of the right atrium and right ventricular systolic function.

We included in the study 50 asymptomatic patients following corrective surgery of tetralogy of Fallot, comparing them to 30 normal subjects. Right atrial areas were measured by echocardiography, and the active fractional area of emptying was expressed, in percentages, as the area measured at the onset of atrial contraction, minus the minimal area, divided by the area at the onset of atrial contraction. We used this value to assess the atrial pump function. Right atrial peak strain rates were measured by tissue Doppler imaging. Compared to controls, patients with tetralogy of Fallot had a significantly reduced right atrial active fractional area of emptying (p = 0.005), along with a reduced peak late diastolic strain rate (p = 0.002). Among 20 patients who underwent magnetic resonance tomographic examination, a relatively higher right atrial peak late diastolic strain rate was shown in patients with a right ventricular ejection fraction of less than 50% (p = 0.021).

Right atrial performance is reduced in patients after surgical correction of tetralogy of Fallot. When facing right ventricular systolic dysfunction, nonetheless, the right atrial pump function may be relatively enhanced. Tissue Doppler derived strain rate can provide quantitative analysis of regional right atrial performance.

Keywords

Tissue Doppler imagingatrial pump functioncongenital cardiac disease
Type
Original Article
Information
Cardiology in the Young , Volume 14 , Issue 5 , October 2004 , pp. 520 - 526
Copyright
© 2004 Cambridge University Press

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

Meijboom F, Szatmari A, Deckers JW, et al. Cardiac status and health-related quality of life in the long term after surgical repair of tetralogy of Fallot in infancy and childhood. J Thorac Cardiovasc Surg 1995; 110: 883–891.Google Scholar
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.Google Scholar
Carvalho JS, Shinebourne EA, Busst C, Rigby ML, Redington AN. Exercise capacity after complete repair of tetralogy of Fallot: deleterious effects of residual pulmonary regurgitation. Br Heart J 1992; 67: 470–473.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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 Scholar
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.Google Scholar
Rossi A, Zardini P, Marino P. Modulation of left atrial function by ventricular filling impairment. Heart Fail Rev 2000; 5: 325–331.Google Scholar
Weidemann F, Eyskens B, Mertens L, et al. Quantification of regional right and left ventricular function by ultrasonic strain rate and strain indexes after surgical repair of tetralogy of Fallot. Am J Cardiol 2002; 90: 133–138.Google Scholar
D’Hooge J, Heimdal A, Jamal F, et al. Regional strain and strain rate measurements by cardiac ultrasound: principles, implementation and limitations. Eur J Echocardiogr 2000; 1: 154–170.Google Scholar
Barbier P, Solomon SB, Schiller NB, Glantz SA. Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function. Circulation 1999; 100: 427–436.Google Scholar
Vogel M, Gutberlet M, Dittrich S, Hosten N, Lange PE. Comparison of transthoracic three dimensional echocardiography with magnetic resonance imaging in the assessment of right ventricular volume and mass. Heart 1997; 78: 127–130.Google Scholar
de Ruijter FT, Weenink I, Hitchcock FJ, Meijboom EJ, Bennink GB. Right ventricular dysfunction and pulmonary valve replacement after correction of tetralogy of Fallot. Ann Thorac Surg 2002; 73: 1794–1800; discussion 1800.Google Scholar
Krymsky LD. Pathologic anatomy of congenital heart disease. Circulation 1965; 32: 814–827.Google Scholar
Davlouros PA, Kilner PJ, Hornung TS, et al. Right ventricular function in adults with repaired tetralogy of Fallot assessed with cardiovascular magnetic resonance imaging: detrimental role of right ventricular outflow aneurysms or akinesia and adverse right-to-left ventricular interaction. J Am Coll Cardiol 2002; 40: 2044–2052.Google Scholar
Vogel M, Sponring J, Cullen S, Deanfield JE, Redington AN. Regional wall motion and abnormalities of electrical depolarization and repolarization in patients after surgical repair of tetralogy of Fallot. Circulation 2001; 103: 1669–1673.Google Scholar
Yamaguchi M, Arakawa M, Tanaka T, Takaya T, Nagano T, Hirakawa S. Study on left atrial contractile performance-participation of Frank-Starling mechanism. Jpn Circ J 1987; 51: 1001–1009.Google Scholar
Norgard G, Gatzoulis MA, Josen M, Cullen S, Redington AN. Does restrictive right ventricular physiology in the early postoperative period predict subsequent right ventricular restriction after repair of tetralogy of Fallot? Heart 1998; 79: 481–484.Google Scholar