Department of Cardiology, Tenri Hospital, Tenri, Japan.
Congenital Heart Disease Center, Tenri Hospital, Tenri, Japan.
Int J Cardiovasc Imaging. 2021 Feb;37(2):569-576. doi: 10.1007/s10554-020-02045-7. Epub 2020 Oct 2.
Several studies have reported a correlation between right ventricular (RV) and left ventricular (LV) systolic dysfunction in adults with repaired tetralogy of Fallot (TOF). However, data are lacking regarding the relationship between RV and LV diastolic dysfunction assessed by 2-dimensional speckle-tracking echocardiography. We studied 69 adults with repaired TOF (mean age 34 years, 61% male) who had been regularly followed up and had routinely undergone echocardiography. In addition to conventional echocardiography, global longitudinal strain (GLS) and early diastolic strain rate (SRe) of both ventricles were assessed using 2-dimensional speckle-tracking echocardiography. Results were compared with 30 age- and sex-matched controls. RV and LV GLS were decreased in TOF patients compared with controls (- 18.4 ± 3.3% vs. -23.5 ± 4.2%, p < 0.001 and - 16.0 ± 3.8% vs. -20.0 ± 3.0%, p < 0.001, respectively). RV and LV SRe were also decreased in TOF patients compared with controls (1.22 ± 0.34 sec vs. 1.47 ± 0.41 sec, p = 0.003 and 1.29 ± 0.42 sec vs. 1.63 ± 0.42 sec, p < 0.001, respectively). A correlation between RV and LV SRe was found in TOF patients (r = 0.43, p < 0.001) as well as between RV and LV GLS (r = 0.45, p < 0.001). Two-dimensional speckle-tracking echocardiography reveals subclinical RV and LV diastolic dysfunction in adults with repaired TOF. A correlation is observed between RV and LV diastolic dysfunction as well as between RV and LV systolic dysfunction.
几项研究报告称，在修复后的法洛四联症（TOF）成人中，右心室（RV）和左心室（LV）收缩功能之间存在相关性。然而，关于通过二维斑点追踪超声心动图评估的 RV 和 LV 舒张功能障碍之间的关系的数据尚缺乏。我们研究了 69 名接受修复的 TOF 成年患者（平均年龄 34 岁，61%为男性），这些患者定期接受随访，并常规接受超声心动图检查。除了常规超声心动图外，还使用二维斑点追踪超声心动图评估了两个心室的整体纵向应变（GLS）和舒张早期应变率（SRe）。结果与 30 名年龄和性别匹配的对照组进行了比较。与对照组相比，TOF 患者的 RV 和 LV GLS 降低（-18.4±3.3%对-23.5±4.2%，p<0.001和-16.0±3.8%对-20.0±3.0%，p<0.001）。与对照组相比，TOF 患者的 RV 和 LV SRe 也降低（1.22±0.34 sec 对 1.47±0.41 sec，p=0.003 和 1.29±0.42 sec 对 1.63±0.42 sec，p<0.001）。TOF 患者中发现 RV 和 LV SRe 之间存在相关性（r=0.43，p<0.001）以及 RV 和 LV GLS 之间存在相关性（r=0.45，p<0.001）。二维斑点追踪超声心动图显示修复后的 TOF 成人存在亚临床 RV 和 LV 舒张功能障碍。观察到 RV 和 LV 舒张功能障碍以及 RV 和 LV 收缩功能障碍之间存在相关性。
