Rácz Gergely, Kormányos Árpád, Domsik Péter, Kalapos Anita, Gyenes Nándor, Havasi Kálmán, Ambrus Nóra, Hartyánszky István, Bogáts Gábor, Nemes Attila
2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
Cardiovasc Diagn Ther. 2021 Apr;11(2):611-622. doi: 10.21037/cdt-20-366.
Aortopathy is a common phenomenon in tetralogy of Fallot (TOF). The current study was designed to detect left ventricular (LV) deformation abnormalities and its relation to aortic stiffness in corrected TOF (cTOF) using the novel three-dimensional (3D) speckle-tracking echocardiography (3DSTE). Detailed comparative analysis between patients with early palliation-late correction (pcTOF) and early total reconstruction (etrTOF) was also performed.
The present study consisted of 28 cTOF patients (35.0±15.7 years, 11 males) from which 15 and 13 proved to be pcTOF and etrTOF, respectively. Their clinical parameters were compared to those of 39 matched healthy adults (35.5±6.0 years, 16 males).
cTOF patients showed significantly lower global LV longitudinal, circumferential and area strains as compared to controls. In etrTOF patients, global LV 3D strain was higher than in controls. In pcTOF patients, all LV strains proved to be significantly lower as compared to those of etrTOF patients and controls. In all cTOF patients, several moderate correlations could be detected between LV strain parameters and aortic elastic properties.
Significant LV deformational abnormalities could be demonstrated in cTOF patients. etrTOF patients have beneficial LV strain parameters as compared to those of pcTOF patients. LV strains show correlations with aortic elastic properties.
主动脉病变是法洛四联症(TOF)中的常见现象。本研究旨在使用新型三维(3D)斑点追踪超声心动图(3DSTE)检测矫正型TOF(cTOF)患者的左心室(LV)变形异常及其与主动脉僵硬度的关系。还对早期姑息-晚期矫正(pcTOF)和早期完全重建(etrTOF)患者进行了详细的对比分析。
本研究纳入了28例cTOF患者(年龄35.0±15.7岁,男性11例),其中15例和13例分别为pcTOF和etrTOF。将他们的临床参数与39名匹配的健康成年人(年龄35.5±6.0岁,男性16例)的参数进行比较。
与对照组相比,cTOF患者的左心室整体纵向、圆周和面积应变显著降低。在etrTOF患者中,左心室整体3D应变高于对照组。在pcTOF患者中,所有左心室应变均显著低于etrTOF患者和对照组。在所有cTOF患者中,左心室应变参数与主动脉弹性特性之间存在若干中度相关性。
cTOF患者可出现明显的左心室变形异常。与pcTOF患者相比,etrTOF患者的左心室应变参数更有利。左心室应变与主动脉弹性特性相关。