Tanasan Asadolah, Zanjani Keyhan Sayadpour, Kocharian Armen, Kiani Abdolrazagh, Navabi Mohammad Ali
Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran.
J Tehran Heart Cent. 2012 Nov;7(4):160-3. Epub 2012 Nov 30.
Longer survival after the total repair of the Tetralogy of Fallot increases the importance of late complications such as right ventricular dysfunction. This is a prospective study of the right ventricular function in totally corrected Tetralogy of Fallot patients versus healthy children.
Thirty-two healthy children were prospectively compared with 30 totally corrected Tetralogy of Fallot patients. Right ventricular myocardial tissue velocities, right ventricular myocardial performance index, and tricuspid annular plane systolic excursion were investigated as well as the presence and severity of pulmonary regurgitation.
The two groups were age-and sex-matched. Mean systolic peak velocity (Sa) and tricuspid annular plane systolic excursion were significantly decreased, while myocardial performance index and early to late diastolic velocity (Ea/Aa) were significantly increased in the Tetralogy of Fallot patients. Early diastolic velocity (Ea) showed no significant difference between the two groups. Sa correlated significantly with tricuspid annular plane systolic excursion in both the normal children and totally corrected Tetralogy of Fallot patients. Myocardial performance index was significantly higher in the patients with moderate to severe pulmonary regurgitation than in those with mild regurgitation. However, there was no significant correlation between this index and right ventricular myocardial tissue velocities.
In this study, systolic right ventricular function indices (Sa and tricuspid annular plane systolic excursion) were impaired in the totally corrected Tetralogy of Fallot patients. Myocardial performance index was affected by the severity of pulmonary regurgitation.
法洛四联症完全修复术后生存期延长,增加了诸如右心室功能障碍等晚期并发症的重要性。这是一项关于法洛四联症完全矫正患者与健康儿童右心室功能的前瞻性研究。
前瞻性地将32名健康儿童与30名法洛四联症完全矫正患者进行比较。研究了右心室心肌组织速度、右心室心肌性能指数、三尖瓣环平面收缩期位移以及肺反流的存在和严重程度。
两组在年龄和性别上相匹配。法洛四联症患者的平均收缩期峰值速度(Sa)和三尖瓣环平面收缩期位移显著降低,而心肌性能指数和舒张早期至晚期速度(Ea/Aa)显著升高。舒张早期速度(Ea)在两组之间无显著差异。正常儿童和法洛四联症完全矫正患者中,Sa与三尖瓣环平面收缩期位移均显著相关。中重度肺反流患者的心肌性能指数显著高于轻度反流患者。然而,该指数与右心室心肌组织速度之间无显著相关性。
在本研究中,法洛四联症完全矫正患者的右心室收缩功能指标(Sa和三尖瓣环平面收缩期位移)受损。心肌性能指数受肺反流严重程度的影响。