Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA 90095, USA.
Can J Cardiol. 2013 Jul;29(7):866-72. doi: 10.1016/j.cjca.2012.11.003. Epub 2013 Jan 28.
Our purpose was to assess the prevalence and clinical implications of left ventricular (LV) and right ventricular (RV) diastolic dysfunction (DD) in patients with repaired tetralogy of Fallot (TOF).
Adults with repaired TOF at 11 North American congenital heart disease centres were included. Of 556 patients analyzed, 325 had sufficient Doppler data to evaluate for LV DD, defined as mitral lateral e' < 10 cm/s and E/e' ratio > 9. Abnormal RV diastolic function was defined as tricuspid E/A ratio of 0.8 to 2.1 with E/e' ratio > 6 or a tricuspid ratio E/A > 2.1 with a deceleration time < 120 milliseconds, and 105 patients were found to have sufficient Doppler data.
Abnormal LV diastolic Doppler indices were prevalent in 13.8% and associated with hypertension, dyslipidemia, 3 or more cardiac operations, and a history of ventricular tachycardia. Abnormal RV indices were prevalent in 52.4% and associated with hypertension, dyslipidemia, diabetes mellitus, and 3 or more cardiac operations. Ventricular tachycardia was more common in those with abnormal RV diastolic function.
Further prospective studies are needed to evaluate these associations with DD and the impact of treatment risk factors on diastolic function and arrhythmia burden.
我们的目的是评估修复法洛四联症（TOF）患者左心室（LV）和右心室（RV）舒张功能障碍（DD）的患病率及其临床意义。
在 11 个北美先天性心脏病中心纳入了修复 TOF 的成年人。在分析的 556 例患者中，有 325 例有足够的多普勒数据来评估 LV DD，定义为二尖瓣侧壁 e' < 10 cm/s 和 E/e' 比值> 9。异常 RV 舒张功能定义为三尖瓣 E/A 比值为 0.8 至 2.1，E/e' 比值> 6，或三尖瓣比值 E/A > 2.1，减速时间< 120 毫秒，有 105 例患者有足够的多普勒数据。
异常 LV 舒张多普勒指数的患病率为 13.8%，并与高血压、血脂异常、3 次或更多次心脏手术和室性心动过速病史相关。异常 RV 指数的患病率为 52.4%，并与高血压、血脂异常、糖尿病和 3 次或更多次心脏手术相关。RV 舒张功能异常者室性心动过速更为常见。
需要进一步前瞻性研究来评估这些与 DD 的相关性，以及治疗危险因素对舒张功能和心律失常负担的影响。
