COMPARATIVE STUDY
JOURNAL ARTICLE

Differential effect of right ventricular dilatation on myocardial deformation in patients with atrial septal defects and patients after tetralogy of Fallot repair

Andreea Dragulescu, Lars Grosse-Wortmann, Andrew Redington, Mark K Friedberg, Luc Mertens
International Journal of Cardiology 2013 September 30, 168 (2): 803-10
23122548

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.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
23122548
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"