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Assessment of inter-atrial, inter-ventricular, and atrio-ventricular interactions in tetralogy of Fallot patients after surgical correction. Insights from two-dimensional speckle tracking and three-dimensional echocardiography

Published online by Cambridge University Press:  23 October 2014

Mohamed Abd El Rahman ,
Tanja Raedle-Hurst ,
Axel Rentzsch ,
Hans-Joachim Schäfers  and
Hashim Abdul-Khaliq
Mohamed Abd El Rahman
Affiliation:
Department of Pediatric Cardiology, Saarland University Hospital, Homburg, Germany Department of Pediatrics and Pediatric Cardiology, Cairo University, Egypt
Tanja Raedle-Hurst
Affiliation:
Department of Pediatric Cardiology, Saarland University Hospital, Homburg, Germany
Axel Rentzsch
Affiliation:
Department of Pediatric Cardiology, Saarland University Hospital, Homburg, Germany
Hans-Joachim Schäfers
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg/Saar, Germany
Hashim Abdul-Khaliq*
Affiliation:
Department of Pediatric Cardiology, Saarland University Hospital, Homburg, Germany
*
Correspondence to: Prof. Dr H. Abdul-Khaliq, MD, PhD, Department of Paediatric Cardiology, Saarland University Hospital, Kirrberger Straße, 66421 Homburg/Saar, Germany. Tel: +496 841 162 8306; Fax: +496 841 162 8330; E-mail: Hashim.Abdul-Khaliq@uniklinikum-saarland.de
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Abstract

Background: We aimed to assess biatrial size and function, interactions on atrial and ventricular levels, and atrio-ventricular coupling in patients after tetralogy of Fallot repair. Methods: A total of 34 patients with a mean age of 20.9±9 years, and 35 healthy controls, underwent two-dimensional speckle tracking echocardiography for ventricular and atrial strain measurements and real-time three-dimensional echocardiography to assess ventricular and atrial volumes. Results: When compared with controls, tetralogy of Fallot patients had significantly reduced right atrial peak atrial longitudinal strain (p<0.01), right atrial peak atrial contraction strain (p<0.01), right atrial ejection fraction (p<0.01), left atrial peak atrial longitudinal strain (p<0.01), left atrial peak atrial contraction strain (p<0.05), and left atrial ejection fraction (p<0.01). In the tetralogy of Fallot group, left ventricular ejection fraction was negatively related to the right ventricular end-systolic volume normalised to body surface area (r=−0.62, p<0.01). An association was found in patients between the right atrial peak longitudinal strain and mean right ventricular strain (r=0.64, p<0.01). In patients, the left atrial peak longitudinal strain correlated negatively with right atrial end-diastolic volume normalised to body surface area (r=−0.67, p<0.01), whereas the left atrial ejection fraction correlated weakly with left ventricular ejection fraction (r=0.41, p<0.05). Conclusions: In asymptomatic tetralogy of Fallot patients, biatrial dysfunction exists and can be quantified via two-dimensional speckle tracking echocardiography as well as real-time three-dimensional echocardiography. Different forms of interactions on atrial and ventricular levels are evident among such cohorts.

Keywords

Tetralogy of Fallotatrial functiontwo-dimensional echocardiographyreal-time three-dimensional echocardiography
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 7 , October 2015 , pp. 1254 - 1262
Copyright
© Cambridge University Press 2014 

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