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Evaluation of right atrial dysfunction in patients with corrected tetralogy of Fallot using 3D speckle-tracking echocardiography

Insights from the CSONGRAD Registry and MAGYAR-Path Study

Untersuchung rechtsatrialer Funktionsstörungen mittels 3-D-Speckle-Tracking-Echokardiographie bei Patienten mit korrigierter Fallot-Tetralogie

Erkenntnisse aus dem CSONGRAD-Register und der MAGYAR-Path-Studie

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Abstract

Background

In recent studies, alterations in ventricular deformations were demonstrated in adult patients with corrected tetralogy of Fallot by three-dimensional speckle-tracking echocardiography. The present study was designed to assess three-dimensional speckle-tracking echocardiography-derived right atrial volumetric and strain parameters in corrected tetralogy of Fallot.

Methods

A total of 17 patients with corrected tetralogy of Fallot were included in the study. Their results were compared with 18 age- and gender-matched healthy controls. Complete two-dimensional echocardiography and three-dimensional speckle-tracking echocardiography were performed in all cases.

Results

Significantly increased right atrial volumes respecting heart cycle were detected in patients with corrected tetralogy of Fallot. Total and passive atrial emptying fractions proved to be significantly decreased in patients with corrected tetralogy of Fallot (26.4 ± 12.4 % vs. 39.1 ± 8.8 %, p = 0.001 and 11.2 ± 6.8 % vs. 19.8 ± 9.0 %, p = 0.003, respectively). Global and mean segmental peak longitudinal (17.3 ± 9.2 % vs. 30.8 ± 11.2 %, p = 0.0007 and 20.6 ± 10.7 % vs. 34.4 ± 10.5 %, p = 0.0005) and area strains (20.1 ± 17.6 % vs. 41.0 ± 19.8 %, p = 0.004 and 28.1 ± 19.8 % vs. 49.1 ± 19.7 %, p = 0.004) as well as global radial peak strain (-9.1 ± 5.1 % vs. -15.0 ± 10.0 %, p = 0.05) were reduced in patients with corrected tetralogy of Fallot compared with controls.

Conclusions

The complexity of right atrial dysfunction can be demonstrated by three-dimensional speckle-tracking echocardiography in patients with corrected tetralogy of Fallot.

Zusammenfassung

Hintergrund

In aktuellen Studien ließen sich Veränderungen der ventrikulären Verformbarkeit bei erwachsenen Patienten mit korrigierter Fallot-Tetralogie durch dreidimensionale Speckle-Tracking-Echokardiographie nachweisen. Die vorliegende Studie diente der Untersuchung von rechtsatrialen volumetrischen und Deformationsparametern, die mittels dreidimensionaler Speckle-Tracking-Echokardiographie bei korrigierter Fallot-Tetralogie erhoben wurden.

Methoden

Es wurden 17 Patienten mit korrigierter Fallot-Tetralogie in die Studie eingeschlossen. Deren Ergebnisse wurden mit 18 nach Alter und Geschlecht entsprechend ausgewählten Kontrollen verglichen. In allen Fällen wurden eine vollständige zweidimensionale Echokardiographie und eine dreidimensionale Speckle-Tracking-Echokardiographie durchgeführt.

Ergebnisse

Bei den Patienten mit korrigierter Fallot-Tetralogie wurden signifikant erhöhte rechtsatriale Volumina unter Berücksichtigung des Herzzyklus festgestellt. Die Gesamt- und die passive atriale Entleerungsfraktion stellten sich bei Patienten mit korrigierter Fallot-Tetralogie als signifikant vermindert heraus (26,4 ± 12,4 % vs. 39,1 ± 8,8 %; p = 0,001 bzw. 11,2 ± 6,8 % vs. 19,8 ± 9,0 %; p = 0,003). Die globale und mittlere segmentale longitudinale Spitzen- (17,3 ± 9,2 % vs. 30,8 ± 11,2 %; p = 0,0007 und 20,6 ± 10,7 % vs. 34,4 ± 10,5 %; p = 0,0005) und flächige Deformation (20,1 ± 17,6 % vs. 41,0 ± 19,8 %; p = 0,004 und 28,1 ± 19,8 % vs. 49,1 ± 19,7 %; p = 0,004) sowie die globale radiale Spitzendeformation (-9,1 ± 5,1 % vs. -15,0 ± 10,0 %; p = 0,05) erwiesen sich bei Patienten mit korrigierter Fallot-Tetralogie gegenüber den Kontrollen als vermindert.

Schlussfolgerung

Mit der dreidimensionalen Speckle-Tracking-Echokardiographie konnte die Komplexität rechtsatrialer Funktionsstörungen bei Patienten mit korrigierter Fallot-Tetralogie gezeigt werden.

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Authors and Affiliations

  1. 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Semmelweis street 6, P.O. Box 427, 6725, Szeged, Hungary

    Attila Nemes MD, PhD, DSc, FESC, Kálmán Havasi MD, Péter Domsik MD, Anita Kalapos MD & Tamás Forster MD, PhD, DSc, FESC, FACC

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  1. Attila Nemes MD, PhD, DSc, FESC
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  2. Kálmán Havasi MD
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  3. Péter Domsik MD
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  4. Anita Kalapos MD
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  5. Tamás Forster MD, PhD, DSc, FESC, FACC
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Correspondence to Attila Nemes MD, PhD, DSc, FESC.

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Conflict of interest

A. Nemes, K. Havasi, P. Domsik, A. Kalapos, and T. Forster state that there are no conflicts of interest.

All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies..

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Nemes, A., Havasi, K., Domsik, P. et al. Evaluation of right atrial dysfunction in patients with corrected tetralogy of Fallot using 3D speckle-tracking echocardiography. Herz 40, 980–988 (2015). https://doi.org/10.1007/s00059-015-4318-z

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  • DOI: https://doi.org/10.1007/s00059-015-4318-z

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