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Two Dimensional Global Longitudinal Strain Rate Is a Preload Independent Index of Systemic Right Ventricular Contractility in Hypoplastic Left Heart Syndrome Patients After Fontan Operation.
MedLine Citation:
PMID:  25270741     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -Assessment of systemic right ventricular (RV) function in patients with hypoplastic left heart syndrome (HLHS) is important during long term follow up after Fontan repair. Traditional echocardiographic parameters to evaluate systolic ventricular function are affected by loading conditions. The only generally accepted load independent parameter of systolic function, end systolic elastance (Ees), requires invasive catheterization. Therefore we sought to determine if parameters obtained by two dimensional speckle tracking (2DST) were affected by acute changes in preload and correlated with catheterization derived indices of RV contractility in HLHS patients after Fontan palliation.
METHODS AND RESULTS: -52 patients with HLHS (median age 6.6 (range 2.9-22.2 years) were prospectively enrolled to have echocardiography and conductance catheter studies performed simultaneously. We compared traditional echo, 2DST and catheterization derived parameters during different states of preload at baseline and during dobutamine infusion. Global longitudinal strain (S) showed a tendency to decrease with preload reduction while global longitudinal strain rate (SR) did not change (S: -17.7±3.4 vs. -16.9±3.8%, p=0.08; SR: -1.30±0.29 vs. -1.34±0.34 s(-1), P=0.3). S did not change with dobutamine infusion (-17.7±3.4 vs. -18.4±3.9%, P=0.24) whereas SR increased significantly (-1.30±0.29 vs. -2.26±0.49 1/s, P<0.001). RV Ees correlated with SR (rs= -0.47, P<0.001), but not with S (rs=0.07, P=0.5) or other echocardiographic parameters.
CONCLUSIONS: -In contrast to S, SR was not affected by preload and correlated with Ees of the systemic RV. SR may be a useful non-invasive surrogate of RV contractility and suitable for follow-up of patients with HLHS after Fontan palliation.
Authors:
Jana Schlangen; Colin Petko; Jan H Hansen; Miriam Michel; Christopher Hart; Anselm Uebing; Gunther Fischer; Kolja Becker; Hans-Heiner Kramer
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-30
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-10-1     Completed Date:  -     Revised Date:  2014-10-2    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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