Document Detail


Altered Diastolic Left Atrial and Ventricular Performance in Asymptomatic Patients After Repair of Tetralogy of Fallot.
MedLine Citation:
PMID:  23179427     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We evaluated the interaction of left atrial and ventricular diastolic performance in asymptomatic children and young adults after ToF-repair (n=25). Those young people, as well as 25 age matched healthy children and young adults were examined using non-invasive conventional echocardiography. Regional systolic and diastolic myocardial strain and strain rate in left atrium and ventricle were analysed using 2D-speckle-tracking (Vivid VII, EchoPacGE). We collected planimetric data about the left atrial and ventricular performance during systole (volumetric LVEF, LV-Tei-Index, MV-E/E'-Ratio) and diastole (LAEF, LVEDV, left atrial volume). Registration of right pulmonary-venous inflow-patterns during ventricular systole, diastole and active atrial contraction was used to support assessment of left atrial function. To verify the timing of left atrial contraction and possible electromechanical delay we measured several ECG-related time-intervals. Statistical analysis included Mann-Whitney-U-Test, Bonferroni-Holm-Test and two-tailed Spearman-Correlation. Systolic pulmonary-venous inflow in ToF-patients was not different compared to the controls. Early diastolic pulmonary-venous inflow was significantly higher in ToF-patients as well as the LV-Tei-Index. The MV-E/E'-ratio, which is closely related to LVEDP, was significantly higher in ToF-patients and correlated with the early diastolic pulmonary venous inflow parameters such as the maximum diastolic bloodflow speed. Diastolic left atrial and ventricular strain and strain rate in ToF-patients did not differ from those in the controls. During late diastole there was a significantly premature timing of maximum myocardial strain rate of the interatrial septum and time-ratio of P-wave origin to maximum reverse pulmonary-venous blood flow and the duration of one heart action. Furthermore the maximum late diastolic reverse pulmonary-venous blood flow was significantly higher in ToF-patients. Those observations indicate a premature active left atrial contraction in late diastole in ToF-patients compared to the controls. In asymptomatic young patients after ToF-repair earlier and increased left atrial contraction was found, which may indicate adaptive compensatory mechanisms to overcome latent and asymptomatic altered systolic and diastolic left ventricular performance. Extensive assessment of left atrial parameters including the pulmonary veins should be considered in terms of an entire evaluation of left heart function in patients after ToF-repair.
Authors:
Karsten Koenigstein; Tanja Raedle-Hurst; Meryem Hosse; Maxi Hauser; Hashim Abdul-Khaliq
Related Documents :
12239207 - Gender differences in the management and outcome of patients with acute coronary artery...
12776947 - Beating heart coronary artery bypass grafting: results from 402 patients and the useful...
9387067 - Severe myocardial dysfunction and coronary revascularization.
15497147 - Safety and efficacy of combined orthotopic liver transplantation and coronary artery by...
22014487 - Assessment of myocardial ischemia with cardiovascular magnetic resonance.
15637087 - The impact of the introduction of drug-eluting stents on the clinical practice of surgi...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-24
Journal Detail:
Title:  Pediatric cardiology     Volume:  -     ISSN:  1432-1971     ISO Abbreviation:  Pediatr Cardiol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Clinic for Paediatric Cardiology, Saarland University Hospital, 66421, Homburg/Saar, Germany, karstenkoenigstein@gmx.de.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Atrial Septal Hematoma After Mitral Valve and Left Coronary Artery Surgery in a Child.
Next Document:  Maternal Antibody-Associated Fetal Second-Degree Heart Block and Atrial Flutter: Case Report and Rev...