Department of Congenital Heart Disease and Paediatric Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany.
Department of Paediatric Cardiology, Children's Hospital of Zurich, Zurich, Switzerland.
Int J Cardiovasc Imaging. 2021 Aug;37(8):2549-2559. doi: 10.1007/s10554-021-02230-2. Epub 2021 Mar 31.
Ventricular dysfunction is a well-known complication in single ventricle patients in Fontan circulation. As studies exclusively examining patients with a single left ventricle (SLV) are sparse, we assessed left ventricular (LV) function in SLV patients by using 2D-cardiovascular magnetic resonance (CMR) feature tracking (2D-CMR-FT) and 2D-speckle tracking echocardiography (2D-STE). 54 SLV patients (11.4, 3.1-38.1 years) and 35 age-matched controls (12.3, 6.3-25.8 years) were included. LV global longitudinal, circumferential and radial strain (GLS, GCS, GRS) and strain rate (GLSR, GCSR, GRSR) were measured using 2D-CMR-FT. LV volumes, ejection fraction (LVEF) and mass were determined from short axis images. 2D-STE was applied in patients to measure peak systolic GLS and GLSR. In a subgroup analysis, we compared double inlet left ventricle (DILV) with tricuspid atresia (TA) patients. The population consisted of 19 DILV patients, 24 TA patients and 11 patients with diverse diagnoses. 52 patients were in NYHA class I and 2 patients were in class II. Most SLV patients had a normal systolic function but median LVEF in patients was lower compared to controls (55.6% vs. 61.2%, p = 0.0001). 2D-CMR-FT demonstrated reduced GLS, GCS and GCSR values in patients compared to controls. LVEF correlated with GS values in patients (p < 0.05). There was no significant difference between GLS values from 2D-CMR-FT and 2D-STE in the patient group. LVEF, LV volumes, GS and GSR (from 2D-CMR-FT) were not significantly different between DILV and TA patients. Although most SLV patients had a preserved EF derived by CMR, our results suggest that, LV deformation and function may behave differently in SLV patients compared to healthy subjects.
心室功能障碍是 Fontan 循环中单心室患者的一种众所周知的并发症。由于专门研究单左心室（SLV）患者的研究很少，我们使用二维心血管磁共振（CMR）特征追踪（2D-CMR-FT）和二维斑点追踪超声心动图（2D-STE）评估 SLV 患者的左心室（LV）功能。纳入 54 例 SLV 患者（11.4 岁，3.1-38.1 岁）和 35 名年龄匹配的对照组（12.3 岁，6.3-25.8 岁）。使用 2D-CMR-FT 测量 LV 整体纵向、周向和径向应变（GLS、GCS、GRS）和应变率（GLSR、GCSR、GRSR）。从短轴图像确定 LV 容积、射血分数（LVEF）和质量。2D-STE 应用于患者测量收缩期峰值 GLS 和 GLSR。在亚组分析中，我们比较了双入口左心室（DILV）和三尖瓣闭锁（TA）患者。该人群包括 19 例 DILV 患者、24 例 TA 患者和 11 例具有不同诊断的患者。52 例患者为纽约心脏协会（NYHA）心功能分级 I 级，2 例为 II 级。大多数 SLV 患者的收缩功能正常，但与对照组相比，患者的中位 LVEF 较低（55.6%比 61.2%，p=0.0001）。2D-CMR-FT 显示与对照组相比，患者的 GLS、GCS 和 GCSR 值降低。LVEF 与患者的 GS 值相关（p<0.05）。患者组中 2D-CMR-FT 和 2D-STE 的 GLS 值之间无显著差异。DILV 和 TA 患者的 LVEF、LV 容积、GS 和 GSR（来自 2D-CMR-FT）无显著差异。尽管大多数 SLV 患者通过 CMR 获得了保留的 EF，但我们的结果表明，与健康受试者相比，LV 变形和功能在 SLV 患者中可能表现不同。
