Department of Pediatrics, University of Tokushima, Tokushima, Japan.
J Am Soc Echocardiogr. 2011 Nov;24(11):1205-12. doi: 10.1016/j.echo.2011.06.016. Epub 2011 Aug 6.
The aim of this study was to evaluate functional differences between the left and right sides of the ventricular septum in children with right ventricular overload.
Radial, longitudinal, and circumferential strain on both sides of the ventricular septum were compared using speckle-tracking echocardiography in patients with preoperative atrial septal defects (n = 22), postoperative tetralogy of Fallot (n = 23) and age-matched normal controls (n = 44). The duration between peak strain of the left and right ventricular septum (TLt-Rt) was also evaluated.
Radial and circumferential strain in the control group were significantly higher on the left than the right ventricular septum (41.3 ± 12.8% vs 22.6 ± 6.8% and -28.0 ± 5.4% vs -22.5 ± 4.8%, respectively; P < .0001 for both), whereas longitudinal strain did not significantly differ (-22.0 ± 4.9% and -20.7 ± 5.2%, respectively). TLt-Rt was 52.9 ± 35.6, 33.4 ± 29.0, and 38.7 ± 31.0 msec for radial, longitudinal, and circumferential strain, respectively. Longitudinal and circumferential strain on both sides were significantly increased in patients with atrial septal defects compared with controls (P < .05), although radial strain was similar on both sides. Radial strain on the right side was significantly increased in patients with tetralogy of Fallot compared with controls (P < .05), whereas that on the left side was significantly reduced (P < .001). Longitudinal strain on both sides was significantly decreased (P < .01 and P < .001 for the left and right sides, respectively). In addition, TLt-Rt in patients with tetralogy of Fallot was significantly increased with radial and circumferential deformation (P < .05 for both).
Deformation of both sides of the ventricular septum functionally differed. Bilayer analysis of the ventricular septum can help in the evaluation of right ventricular performance under volume and pressure overload.
本研究旨在评估右心室负荷过重患儿室间隔两侧的功能差异。
使用斑点追踪超声心动图比较术前房间隔缺损（n=22）、术后法洛四联症（n=23）患者及年龄匹配的正常对照组（n=44）室间隔两侧的径向、纵向和环向应变。还评估了左、右室间隔峰值应变之间的时间（TLt-Rt）。
对照组室间隔左侧的径向和环向应变明显高于右侧（分别为 41.3±12.8% vs 22.6±6.8%和-28.0±5.4% vs -22.5±4.8%；P均<.0001），而纵向应变无明显差异（分别为-22.0±4.9%和-20.7±5.2%）。TLt-Rt 在径向、纵向和环向应变分别为 52.9±35.6、33.4±29.0 和 38.7±31.0 msec。与对照组相比，房间隔缺损患者两侧的纵向和环向应变均显著增加（P<.05），尽管两侧的径向应变相似。与对照组相比，法洛四联症患者右侧的径向应变显著增加（P<.05），而左侧的应变显著降低（P<.001）。两侧的纵向应变均显著降低（左侧和右侧分别为 P<.01 和 P<.001）。此外，法洛四联症患者的 TLt-Rt 与径向和环向变形显著增加（两者均为 P<.05）。
室间隔两侧的变形存在功能差异。室间隔的双层分析有助于评估容量和压力负荷过重时右心室的功能。
