Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-23T05:25:21.840Z Has data issue: false hasContentIssue false

Role of speckle tracking echocardiography in the assessment of post-repair left ventricular function in patients with late presentation of anomalous origin of the left coronary artery from the pulmonary artery

Published online by Cambridge University Press:  22 August 2014

Gholamhosein Ajami
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
Mohammad R. Edraki
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
Ali R. Moarref
Affiliation:
Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Ahmad A. Amirghofran
Affiliation:
Department of Surgery, Division of Cardiac Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
Mohammad Borzouee
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
Hamid Amoozgar*
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
Sirous Cheriki
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
Ali M. Shakiba
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
*
Correspondence to: Prof. H. Amoozgar, MD, Department of Pediatrics, Namazi Hospital, Shiraz 71937-11351, Iran. Tel: +98 9173111877; Fax:+98 711 6474298; E-mail: [email protected]

Abstract

The aim of this study was to determine the left ventricular myocardial deformation and segmental myocardial dysfunction by speckle tracking echocardiography and tissue Doppler imaging among the operated patients with anomalous origin of the left coronary artery from the pulmonary artery. The study was conducted on 12 patients diagnosed with anomalous origin of the left coronary artery from the pulmonary artery, who had been operated upon between 2001 and 2013 at the medical centres of Shiraz University of Medical Sciences, Shiraz, Iran. The mean age of the patients at the time of surgical correction was 12.6 years ranging from 6 months to 43 years, and the duration of postoperative follow-up was between 1 and 12 years. Comparison of the strain rate between the patients with acceptable ejection fraction and the control group by tissue Doppler imaging showed significant differences between the two groups regarding the lateral wall (p<0.001), but not the septal wall of the left ventricle (p=0.65). Moreover, the strain values by the speckle tracking method revealed significant differences between the patient and the control group regarding the global strain (p=0.016) and anterior, lateral, and posterior segments of the left ventricle. Although postoperative conventional echocardiography revealed normal global left ventricular function with acceptable ejection fraction, abnormal myocardial deformation of the variable segments of the left ventricle with regional and global myocardial dysfunction were well defined by speckle tracking echocardiography.

Type
Original Articles
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. KO, L, Chu, A, Young, T, Cheung, Y, Lun, K. Retrospective review on anomalous left coronary artery from pulmonary artery. Hong Kong J Paediatr 2010; 15: 1218.Google Scholar
2. Wesselhoeft, H, Fawcett, JS, Johnson, AL. Anomalous origin of the left coronary artery from the pulmonary trunk. Its clinical spectrum, pathology, and pathophysiology, based on a review of 140 cases with seven further cases. Circulation 1968; 38: 403425.Google Scholar
3. Lange, R, Vogt, M, Horer, J, et al. Long-term results of repair of anomalous origin of the left coronary artery from the pulmonary artery. Ann Thorac Surg 2007; 83: 14631471.Google Scholar
4. Shavilkar, B, Borgers, M, Daenen, W, Gewillig, M, Flameng, W. Anomalous origin of the left coronary artery from the pulmonary artery syndrome: an example of chronic myocardial hypoperfusion. J Am Coll Cardiol. 1994; 23: 772778.Google Scholar
5. Azakie, A, Russell, JL, Mccrindle, BW, et al. Anatomic repair of anomalous left coronary artery from the pulmonary artery by aortic reimplantation: early survival, patterns of ventricular recovery and late outcome. Ann Thorac Surg 2003; 75: 15351541.Google Scholar
6. Kazmierczak, PA, Ostrowska, K, Dryzek, P, Moll, JA, Moll, JJ. Repair of anomalous origin of the left coronary artery from the pulmonary artery in infants. Interact Cardiovasc Thorac surg 2013; 16: 797801.Google Scholar
7. Sileikiene, R, Vaskelyte, J, Mizariene, V. Speckle tracking derived left and right atrial, left and right ventricular strain, strain rate after atrioventricular node slow pathway radiofrequency ablation. Electron Electric Eng 2011; 3: 5762.Google Scholar
8. Fratz, S, Hauser, M, Bengel, FM, et al. Myocardial scars determined by delayed-enhancement magnetic resonance imaging and positron emission tomography are not common in right ventricles with systemic function in long-term follow-up. Heart 2006; 92: 16731677.Google Scholar
9. Shan, K, Constantine, G, Sivananthan, M, Scott, DF. Role of cardiac magnetic resonance imaging in the assessment of myocardial viability. Circulation 2006; 109: 13281334.Google Scholar
10. Dandel, M, Lehmkuhl, H, Knosalla, C, et al. Strain and strain rate imaging by echocardiography – basic concepts and clinical applicability. Curr Cardiol Rev 2009; 5: 133148.Google Scholar
11. LHB, Baur. Strain and strain rate imaging: a promising tool for evaluation of ventricular function. Int J Cardiovasc Imaging 2008; 24: 493494.Google Scholar
12. Vrain, JS, Bilhorn, K, Kurup, S, Linda, RP. Strain imaging using speckle tracking in the cardiometabolic syndrome: method and utility. J Cardiometab Syndr 2008; 3: 258261.Google Scholar
13. Lorch, SM, Ludomirsky, A, Singh, GK. Maturational and growth-related changes in left ventricular longitudinal strain and strain rate measured by two dimentional speckle tracking echocardiography in healthy pediatric population. J Am Soc Echo 2008; 21: 12071215.Google Scholar
14. Hauser, M. Congenital anomalies of the coronary arteries. Heart 2005; 91: 12401245.CrossRefGoogle ScholarPubMed
15. Iriart, X, Jalal, Z, Derval, N, Latrabe, V, Thambo, JB. Two dimensional strain as a marker of subclinical anterior ischemia in anomaly of left coronary artery arising from pulmonary artery. Eur J Echocardiogr 2009; 10: 732735.Google Scholar
16. Popovic, ZB, Benejam, C, Bian, J, et al. Speckle tracking echocardiography correctly identifies segmental left ventricular dysfunction induced by scarring in a rat model of myocardial infarction. Am J Physiol Heart Circ Physiol 2007; 292: 28092816.Google Scholar
17. Secinaro, A, Ntsinjana, H, Tann, O, et al. Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection. J Cardiovasc Magn Reson 2011; 13: 2733.Google Scholar