Eroğlu Ayşe G, Gökalp Selman, Atik Sezen U, Önal Damla, Acar Hazal C, Saltık Levent
Cerrahpaşa Faculty of Medicine, Department of Pediatrics, Division of Pediatric Cardiology, İstanbul University-Cerrahpaşa, İstanbul, Turkey.
Cerrahpaşa Faculty of Medicine, Department of Pediatrics, İstanbul University-Cerrahpaşa, İstanbul, Turkey.
Cardiol Young. 2022 Dec;32(12):1901-1909. doi: 10.1017/S1047951121005126. Epub 2022 Jan 6.
The left and right ventricular dysfunction are important clinical course indicators in patients with repaired tetralogy of Fallot. This study aimed to evaluate ventricular volumes, functions, and myocardial deformation in children with repaired tetralogy of Fallot by real-time three-dimensional (four-dimensional) echocardiography and compared with healthy children. It also aimed to investigate the relationships between ventricular volumes, functions, and myocardial deformation parameters in the patients.
In this cross-sectional study, 35 patients (mean age 15.1 ± 2.8 years, 54% male) and 35 healthy controls of similar age, gender, and body measurements underwent echocardiography. End-diastolic volume index, end-systolic volume index, and ejection fractions of both ventricles; global longitudinal, circumferential, radial strain, twist, and torsion of the left ventricle; the longitudinal strain of the right ventricle free wall and septum were measured.
Left ventricular ejection fraction, global circumferential and radial strain, twist and torsion were significantly lower in patients compared with controls. Left ventricular ejection fraction correlated with global circumferential (r = -0.446, p < 0.001) and radial strain (r = -0.433, p < 0.001) in the patients. Right ventricular volumes were significantly higher, and ejection fraction was significantly lower in patients compared with controls. All right ventricular parameters correlated with each other in the patients.
Left ventricular contraction pattern was changed, circumferential and radial fibres were most affected in the patients. Right ventricular dilatation and dysfunction were detected, and right ventricular ejection fraction correlated well with strain measurements of the right ventricle.
左、右心室功能障碍是法洛四联症修补术后患者重要的临床病程指标。本研究旨在通过实时三维（四维）超声心动图评估法洛四联症修补术后患儿的心室容积、功能及心肌变形情况，并与健康儿童进行比较。同时，研究患者心室容积、功能及心肌变形参数之间的关系。
在这项横断面研究中，35例患者（平均年龄15.1±2.8岁，54%为男性）和35名年龄、性别及身体测量指标相似的健康对照者接受了超声心动图检查。测量了双心室的舒张末期容积指数、收缩末期容积指数及射血分数；左心室的整体纵向、圆周、径向应变、扭转及扭矩；右心室游离壁和室间隔的纵向应变。
与对照组相比，患者的左心室射血分数、整体圆周和径向应变、扭转及扭矩显著降低。患者的左心室射血分数与整体圆周应变（r = -0.446，p < 0.001）和径向应变（r = -0.433，p < 0.001）相关。与对照组相比，患者的右心室容积显著更高，射血分数显著更低。患者的所有右心室参数之间相互关联。
患者的左心室收缩模式发生改变，圆周和径向纤维受影响最大。检测到右心室扩张和功能障碍，且右心室射血分数与右心室应变测量值相关性良好。
