Scherptong Roderick W C, Mollema Sjoerd A, Blom Nico A, Kroft Lucia J M, de Roos Albert, Vliegen Hubert W, van der Wall Ernst E, Bax Jeroen J, Holman Eduard R
Department of Cardiology C5-P, Leiden University Medical Centre, Leiden, The Netherlands.
Int J Cardiovasc Imaging. 2009 Oct;25(7):669-76. doi: 10.1007/s10554-009-9477-7. Epub 2009 Jul 30.
The aim of this study was to evaluate the feasibility of right ventricular (RV) longitudinal peak systolic strain (LPSS) assessment for the follow-up of adult patients with corrected tetralogy of Fallot (TOF). Adult patients (n = 18) with corrected TOF underwent echocardiography and CMR twice with a time interval of 4.2 +/- 1.7 years. RV performance was derived from CMR, and included RV volumes and ejection fraction (EF). LPSS was calculated globally (GLPSS) and in the RV free wall (LPSS FW), with echocardiographic speckle-tracking strain-analysis. Baseline (G)LPSS values were compared between patients and healthy controls; the relation between (G)LPSS and CMR parameters was evaluated and the changes in (G)LPSS and CMR parameters during follow-up were compared. GLPSS and LPSS FW were significantly reduced in patients as compared to controls (-14.9 +/- 0.7% vs. -21.6 +/- 0.9% and -15.5 +/- 0.9% vs. -22.7 +/- 1.5%, P < 0.01). Moderate agreement between LPSS and CMR parameters was observed. RV EF remained unchanged during follow-up, whereas GLPSS and LPSS FW demonstrated a significant reduction. RVEF showed a 1% increase, whereas GLPSS decreased by 14%, and LPSS FW by 27%. RV LPSS is reduced in TOF patients as compared to controls; during follow-up RV EF remained unchanged whereas LPSS decreased suggesting that RV LPSS may be a sensitive marker to detect early deterioration in RV performance.
本研究的目的是评估右心室（RV）纵向收缩期峰值应变（LPSS）评估法用于法洛四联症（TOF）矫正术后成年患者随访的可行性。18例TOF矫正术后成年患者接受了超声心动图和心脏磁共振成像（CMR）检查，两次检查间隔时间为4.2±1.7年。通过CMR得出右心室功能指标，包括右心室容积和射血分数（EF）。采用超声心动图斑点追踪应变分析方法，整体计算（GLPSS）和在右心室游离壁计算（LPSS FW）LPSS。比较患者与健康对照者的基线（G）LPSS值；评估（G）LPSS与CMR参数之间的关系，并比较随访期间（G）LPSS和CMR参数的变化。与对照组相比，患者的GLPSS和LPSS FW显著降低（-14.9±0.7%对-21.6±0.9%以及-15.5±0.9%对-22.7±1.5%，P<0.01）。观察到LPSS与CMR参数之间存在中度一致性。随访期间右心室EF保持不变，而GLPSS和LPSS FW显著降低。右心室EF增加了1%，而GLPSS降低了14%，LPSS FW降低了27%。与对照组相比，TOF患者的右心室LPSS降低；随访期间右心室EF保持不变，而LPSS降低，这表明右心室LPSS可能是检测右心室功能早期恶化的敏感指标。
