Document Detail


Echocardiographic assessment of atrial properties in single ventricles vs. normal controls.
MedLine Citation:
PMID:  21501389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Atrial function is increasingly being recognized as a significant factor in overall cardiac function in adults. Limited studies evaluating atrial properties exist in the pediatric congenital heart disease population. The goal of this study was to evaluate atrial properties in patients with single ventricle physiology after Fontan completion and compare these values with normal control patients.
METHODS: Echocardiograms were performed in patients with single ventricular physiology and in control patients. Tissue Doppler and blood flow measurements were obtained. Atrial fraction and atrial electromechanical values were calculated. Differences were assessed with one-way analysis of variance. Post hoc comparisons were performed with Tukey adjustment. P < .05 was considered significant.
RESULTS: No significant difference was present in age or heart rate between single ventricle and control patients. The single right ventricle tricuspid valve A wave (52.6 ± 14.5 vs. 36.7 ± 10.4 cm/s) and atrial fraction (39.2 ± 6.2 vs. 32.7 ± 7.7%) were significantly higher, and the E/A ratio (1.4 + 0.3 vs. 1.8 + 0.4), tricuspid valve E/A velocity-time integral (1.6 + 0.4 vs. 2.2 + 0.7 cm), and late diastolic annular value (5.3 + 1.5 vs. 8.7 + 1.4 cm/s) were significantly lower compared with the controls. The single left ventricle late diastolic annular velocity (4.2 + 1.0 vs. 6.7 + 1.3 cm/s) was significantly lower and atrial fraction was significantly higher compared with the controls (37.7 ± 12.5 vs. 29.8 ± 4.3%). There were no significant differences in atrial electromechanical measurements between groups, but the single right ventricle patients tended to have increased atrial dyssynchrony compared with controls.
CONCLUSIONS: Patients with single ventricle physiology after Fontan completion have differences in atrial properties when compared with normal controls. These differences may have important implications in their long-term outcomes. Further studies are necessary to determine the clinical significance of these findings.
Authors:
Jack R Stines; Jared A Hershenson; John Hayes; Carol A Stefaniak; Karen M Texter; Ali N Zaidi; Clifford L Cua
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Publication Detail:
Type:  Journal Article     Date:  2011-04-19
Journal Detail:
Title:  Congenital heart disease     Volume:  6     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2011 May-Jun
Date Detail:
Created Date:  2011-05-23     Completed Date:  2011-09-16     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  247-52     Citation Subset:  IM    
Copyright Information:
© 2011 Copyright the Authors. Congenital Heart Disease © 2011 Wiley Periodicals, Inc.
Affiliation:
The Heart Center, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio 43205, USA. jack.stines@nationwidechildrens.org
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Atrial Function*
Case-Control Studies
Child
Child, Preschool
Echocardiography, Doppler
Fontan Procedure
Heart Atria / physiopathology,  ultrasonography
Heart Defects, Congenital / physiopathology,  surgery,  ultrasonography*
Heart Ventricles / abnormalities,  physiopathology,  ultrasonography
Humans
Ohio
Predictive Value of Tests
Prospective Studies
Treatment Outcome
Ventricular Function, Left
Ventricular Function, Right

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


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