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Assessment of Myocardial Function in Pediatric Patients with Operated Tetralogy of Fallot: Preliminary Results with 2D Strain Echocardiography

Knirsch, Walter ; Dodge-Khatami, Ali ; Kadner, Alexander ; Kretschmar, Oliver ; Steiner, Johannes ; Böttler, Petra ; Kececioglu, Deniz ; Harpes, Paul ; Valsangiacomo Buechel, Emanuela

In: Pediatric Cardiology, 2008, vol. 29, no. 4, p. 718-725

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    Titre
    • Assessment of Myocardial Function in Pediatric Patients with Operated Tetralogy of Fallot: Preliminary Results with 2D Strain Echocardiography
    Auteur
    • Knirsch, Walter. Division of Pediatric Cardiology, University Children's Hospital Zurich, Steinwiesstr. 75, 8032, Zurich, Switzerland
    • Dodge-Khatami, Ali. Division of Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland
    • Kadner, Alexander. Division of Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland
    • Kretschmar, Oliver. Division of Pediatric Cardiology, University Children's Hospital Zurich, Steinwiesstr. 75, 8032, Zurich, Switzerland
    • Steiner, Johannes. Department of Pediatric Cardiology, University Children's Hospital Freiburg, Freiburg, Germany
    • Böttler, Petra. Department of Pediatric Cardiology, University Children's Hospital Freiburg, Freiburg, Germany
    • Kececioglu, Deniz. Department of Pediatric Cardiology, University Children's Hospital Freiburg, Freiburg, Germany
    • Harpes, Paul. Department of Biostatistics, University of Zurich, Zurich, Switzerland
    • Valsangiacomo Buechel, Emanuela. Division of Pediatric Cardiology, University Children's Hospital Zurich, Steinwiesstr. 75, 8032, Zurich, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:318420
    Summary
    The global myocardial function in patients after repair of tetralogy of Fallot (TOF) can be assessed by cardiovascular magnetic resonance (CMR) and measurement of B-type natriuretic peptides. Two-dimensional echocardiography-derived strain and strain rate (2D strain) facilitate the assessment of regional myocardial function. We evaluated myocardial function in 16 children with residual severe pulmonary valve regurgitation and right ventricular (RV) volume overload after TOF repair before, 1month after, and 6months after pulmonary valve replacement (PVR). In 2D strain echocardiography preoperatively, the longitudinal systolic RV strain was reduced (p<0.05). One month after PVR, longitudinal systolic RV strain decreased further (p<0.05), while systolic and early diastolic radial left ventricular strain and strain rate increased (each p<0.05), followed by a return toward preoperative values after 6months. Six months after PVR, preoperatively elevated RV end-diastolic volume (p<0.01) assessed by CMR and N-terminal pro-B-type natriuretic peptide (p<0.05) decreased. In conclusion, the impairment of the regional myocardial after TOF repair and transient changes after PVR can be subtly analyzed by 2D strain echocardiography in addition to the established assessment of myocardial function with CMR and measurement of B-type natriuretic peptides