Moradian Maryam, Rashidighader Fariba, Golchinnaghash Fatemeh, Meraji Mahmoud, Ghaemi Hamid Reza
Department of Pediatric Cardiology, Rajaei Cardiovascular Research and Medical Center, School of Medicine, Iran University of Medical Sciences, Intersection of Niayesh Highway and Valiasr St, Tehran, 1995614331, Iran.
Egypt Heart J. 2023 Jun 19;75(1):51. doi: 10.1186/s43044-023-00379-w.
In repaired Tetralogy of Fallot (rTOF), pulmonary regurgitation and resulting right ventricular (RV) and left ventricular (LV) dysfunction are associated with adverse clinical outcomes. We performed an echocardiographic assessment of LV and RV function using Global Longitudinal Strain (GLS) and conventional echo method prior to and following Pulmonary Valvular Replacement (PVR) to help inform proper timing of operation.
A total of 30 rTOF patients (12.17 ± 2.5 years, 70% male) were included. Regarding to LV function, the study revealed a significant reverse correlation between LV GLS (absolute value) and early (mean = 10.4 days) and late (mean = 7.4 months) postop LVEF. Paired T-Test showed significant difference between GLS of LV and RV before and late after operation (op), however, without significant changes early postop. Late postop significant improvements occurred in other conventional echo indices of LV and RV function as well. There was also a significant correlation between echo-measured LVEF & Fraction Area Change (RV FAC) and MRI-derived LVEF & RVEF, respectively.
In this cross-sectional study in rTOF patients, RV and LV GLS as well as conventional echocardiographic indices regarding LV and RV function improved significantly after 6 months (mean = 7.4mo) following PVR.
在法洛四联症修复术后（rTOF），肺动脉反流以及由此导致的右心室（RV）和左心室（LV）功能障碍与不良临床结局相关。我们在肺动脉瓣置换术（PVR）前后使用整体纵向应变（GLS）和传统超声心动图方法对左心室和右心室功能进行了超声心动图评估，以帮助确定合适的手术时机。
共纳入30例rTOF患者（年龄12.17±2.5岁，70%为男性）。关于左心室功能，研究显示左心室GLS（绝对值）与术后早期（平均=10.4天）和晚期（平均=7.4个月）的左心室射血分数（LVEF）呈显著负相关。配对t检验显示，术前和术后晚期左心室和右心室的GLS存在显著差异，然而术后早期无显著变化。术后晚期左心室和右心室功能的其他传统超声心动图指标也有显著改善。超声测量的LVEF与面积变化分数（RV FAC）分别与MRI得出的LVEF和右心室射血分数（RVEF）之间也存在显著相关性。
在这项针对rTOF患者的横断面研究中，PVR术后6个月（平均=7.4个月），右心室和左心室GLS以及关于左心室和右心室功能的传统超声心动图指标均有显著改善。
