Eyskens Benedicte, Brown Stephen C, Claus Piet, Dymarkowski Steven, Gewillig Marc, Bogaert Jan, Mertens Luc
Department of Paediatric Cardiology, University Hospital Leuven, Herestraat 49, B 3000 Leuven, Belgium.
Eur J Echocardiogr. 2010 May;11(4):341-5. doi: 10.1093/ejechocard/jep209. Epub 2010 Jan 19.
Pulmonary regurgitation after repair of tetralogy of Fallot (TOF) results in right ventricular (RV) dysfunction with significant late morbidity and mortality. The aim was to assess the influence of pulmonary regurgitation on regional RV function.
In 48 asymptomatic children (age 11.1 +/- 3.3 years) with repair of TOF, peak systolic strain rate (SR) and end-systolic strain (epsilon) were acquired using colour Doppler myocardial imaging. RV indices were quantified by magnetic resonance imaging. Echocardiography and exercise capacity was also performed. Forty complete data sets were analysed. An inverse linear relationship was demonstrated between the degree of pulmonary regurgitation and right ventricle end-systolic epsilon (r = -0.53, P < 0.01) as well as a correlation with peak systolic SR (r = -0.35, P < 0.01). A correlation existed between peak VO(2) and peak systolic SR (r = 0.51, P = 0.001) and end-systolic epsilon (r = 0.33, P < 0.05).
In asymptomatic children after repair of TOF, pulmonary regurgitation is associated with impaired regional systolic RV deformation indices. Regional strain and SR may be an early indicator of RV dysfunction in patients with post-TOF and pulmonary regurgitation.
法洛四联症（TOF）修复术后的肺动脉反流会导致右心室（RV）功能障碍，具有显著的晚期发病率和死亡率。本研究旨在评估肺动脉反流对右心室局部功能的影响。
对48例TOF修复术后无症状儿童（年龄11.1±3.3岁），采用彩色多普勒心肌成像获取收缩期峰值应变率（SR）和收缩末期应变（ε）。通过磁共振成像对右心室指标进行量化。同时进行超声心动图和运动能力评估。分析了40组完整数据集。结果显示，肺动脉反流程度与右心室收缩末期ε呈负线性关系（r = -0.53，P < 0.01），与收缩期峰值SR也存在相关性（r = -0.35，P < 0.01）。峰值摄氧量（VO₂）与收缩期峰值SR（r = 0.51，P = 0.001）以及收缩末期ε（r = 0.33，P < 0.05）之间存在相关性。
在TOF修复术后的无症状儿童中，肺动脉反流与右心室局部收缩期变形指标受损有关。局部应变和SR可能是TOF术后合并肺动脉反流患者右心室功能障碍的早期指标。
