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Abnormal biventricular performance in asymptomatic adolescents late after repaired Tetralogy of Fallot: Combined two-dimensional speckle tracking and three-dimensional echocardiography study.
J Chin Med Assoc. 2018 02; 81(2):170-177.JC

Abstract

BACKGROUND

The aim of this prospective study was to assess biventricular performance in asymptomatic adolescents with repaired tetralogy of Fallot (TOF) using 2D speckle tracking and real time 3D echocardiography simultaneously.

METHODS

We studied 31 patients with repaired TOF (M/F: 22/9, age: 16.1 ± 6.1 yrs) who had history of cardiac surgery with mean follow-up duration of 12.8 years, and 32 age- and sex-matched normal individuals (M/F: 23/9, age: 16.6 ± 5.1 yrs). All subjects underwent speckle tracking and 3D echocardiography, electrocardiogram, treadmill, and blood sampling for measurement of brain natriuretic peptide (BNP).

RESULTS

Compared to the control group, the TOF group had higher BNP level (31.8 ± 21.4 vs 14.1 ± 12.4 pg/ml, p < 0.01), lower peak oxygen consumption (8.4 ± 1.7 vs 9.9 ± 1.6 ml/kg/min, p < 0.05), and longer QRS duration (126 ± 30 vs 82 ± 9 ms, p < 0.01). Patients with repaired TOF had significantly impaired right ventricle (RV) global and all six regional longitudinal strain and strain rate than normal controls. Left ventricle (LV) global and mainly apical regional longitudinal strain and strain rate were reduced in patients with repaired TOF. There was a significant correlation of global longitudinal strain (r = 0.456, p = 0.01) and global time to peak longitudinal strain (r = 0.484, p < 0.01) between LV and RV in patients with repaired TOF. In terms of 3D echo cardiographic volume data, patients with repaired TOF had lower LV stroke volume index (p < 0.05), but higher RV end diastolic volume index (p < 0.01), RV end systolic volume index (p < 0.01), RV stroke volume index (p < 0.01), and pulmonary regurgitation fraction (p < 0.01) than normal controls.

CONCLUSION

Our results suggest asymptomatic adolescents with repaired TOF had abnormal biventricular myocardial performance, as demonstrated by combined 2D speckle-tracking and 3D echocardiography. The implications of these findings for management of adolescents late after repaired TOF remain to be determined.

Authors+Show Affiliations

Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan, ROC; Shu-Zen College of Medicine and Management, Kaohsiung, Taiwan, ROC. Electronic address: kenpenweng@yahoo.com.tw.Department of Pediatrics, St. Joseph Hospital, Kaohsiung, Taiwan, ROC.Department of Nursing, Fooyin University, Kaohsiung, Taiwan, ROC.Department of Pediatrics, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, ROC.Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan, ROC.Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29191613

Citation

Weng, Ken-Pen, et al. "Abnormal Biventricular Performance in Asymptomatic Adolescents Late After Repaired Tetralogy of Fallot: Combined Two-dimensional Speckle Tracking and Three-dimensional Echocardiography Study." Journal of the Chinese Medical Association : JCMA, vol. 81, no. 2, 2018, pp. 170-177.
Weng KP, Hung YC, Huang SH, et al. Abnormal biventricular performance in asymptomatic adolescents late after repaired Tetralogy of Fallot: Combined two-dimensional speckle tracking and three-dimensional echocardiography study. J Chin Med Assoc. 2018;81(2):170-177.
Weng, K. P., Hung, Y. C., Huang, S. H., Wu, H. W., Chien, K. J., Lin, C. C., Peng, H. H., & Wu, M. T. (2018). Abnormal biventricular performance in asymptomatic adolescents late after repaired Tetralogy of Fallot: Combined two-dimensional speckle tracking and three-dimensional echocardiography study. Journal of the Chinese Medical Association : JCMA, 81(2), 170-177. https://doi.org/10.1016/j.jcma.2017.09.012
Weng KP, et al. Abnormal Biventricular Performance in Asymptomatic Adolescents Late After Repaired Tetralogy of Fallot: Combined Two-dimensional Speckle Tracking and Three-dimensional Echocardiography Study. J Chin Med Assoc. 2018;81(2):170-177. PubMed PMID: 29191613.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Abnormal biventricular performance in asymptomatic adolescents late after repaired Tetralogy of Fallot: Combined two-dimensional speckle tracking and three-dimensional echocardiography study. AU - Weng,Ken-Pen, AU - Hung,Yu-Chi, AU - Huang,Shih-Hui, AU - Wu,Huang-Wei, AU - Chien,Kuang-Jen, AU - Lin,Chu-Chuan, AU - Peng,Hsu-Hsia, AU - Wu,Ming-Ting, Y1 - 2017/11/27/ PY - 2017/03/21/received PY - 2017/08/31/revised PY - 2017/09/01/accepted PY - 2017/12/2/pubmed PY - 2018/9/19/medline PY - 2017/12/2/entrez KW - 2D speckle tracking echocardiography KW - Real time 3D echocardiography KW - Strain KW - Strain rate KW - Tetralogy of Fallot SP - 170 EP - 177 JF - Journal of the Chinese Medical Association : JCMA JO - J Chin Med Assoc VL - 81 IS - 2 N2 - BACKGROUND: The aim of this prospective study was to assess biventricular performance in asymptomatic adolescents with repaired tetralogy of Fallot (TOF) using 2D speckle tracking and real time 3D echocardiography simultaneously. METHODS: We studied 31 patients with repaired TOF (M/F: 22/9, age: 16.1 ± 6.1 yrs) who had history of cardiac surgery with mean follow-up duration of 12.8 years, and 32 age- and sex-matched normal individuals (M/F: 23/9, age: 16.6 ± 5.1 yrs). All subjects underwent speckle tracking and 3D echocardiography, electrocardiogram, treadmill, and blood sampling for measurement of brain natriuretic peptide (BNP). RESULTS: Compared to the control group, the TOF group had higher BNP level (31.8 ± 21.4 vs 14.1 ± 12.4 pg/ml, p < 0.01), lower peak oxygen consumption (8.4 ± 1.7 vs 9.9 ± 1.6 ml/kg/min, p < 0.05), and longer QRS duration (126 ± 30 vs 82 ± 9 ms, p < 0.01). Patients with repaired TOF had significantly impaired right ventricle (RV) global and all six regional longitudinal strain and strain rate than normal controls. Left ventricle (LV) global and mainly apical regional longitudinal strain and strain rate were reduced in patients with repaired TOF. There was a significant correlation of global longitudinal strain (r = 0.456, p = 0.01) and global time to peak longitudinal strain (r = 0.484, p < 0.01) between LV and RV in patients with repaired TOF. In terms of 3D echo cardiographic volume data, patients with repaired TOF had lower LV stroke volume index (p < 0.05), but higher RV end diastolic volume index (p < 0.01), RV end systolic volume index (p < 0.01), RV stroke volume index (p < 0.01), and pulmonary regurgitation fraction (p < 0.01) than normal controls. CONCLUSION: Our results suggest asymptomatic adolescents with repaired TOF had abnormal biventricular myocardial performance, as demonstrated by combined 2D speckle-tracking and 3D echocardiography. The implications of these findings for management of adolescents late after repaired TOF remain to be determined. SN - 1728-7731 UR - https://www.unboundmedicine.com/medline/citation/29191613/Abnormal_biventricular_performance_in_asymptomatic_adolescents_late_after_repaired_Tetralogy_of_Fallot:_Combined_two_dimensional_speckle_tracking_and_three_dimensional_echocardiography_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1726-4901(17)30303-9 DB - PRIME DP - Unbound Medicine ER -