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Ventricular and atrial mechanics and their interaction in patients with congenital scoliosis without clinical heart failure

Published online by Cambridge University Press:  12 September 2014

Shujuan Li ,
Junlin Yang ,
Ling Zhu ,
Yuese Lin ,
Xuandi Li ,
Yunquan Li ,
Zifang Huang  and
Huishen Wang
Shujuan Li
Affiliation:
Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Junlin Yang
Affiliation:
Department of Spinal Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Ling Zhu
Affiliation:
Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Yuese Lin
Affiliation:
Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Xuandi Li
Affiliation:
Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Yunquan Li
Affiliation:
Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Zifang Huang
Affiliation:
Department of Spinal Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Huishen Wang*
Affiliation:
Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
*
Correspondence to: Professor H. Wang, Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, 58 2nd Zhongshan Road, Guangzhou, China. Tel: +86 020 87332200 8835; Fax: +86 020 87330808; E-mail: huishenwang@hotmail.com
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Abstract

Objectives: This study sought to evaluate left ventricular, right ventricular, and left atrial mechanics and their interactions in patients with congenital scoliosis without clinical heart failure. Methods: A total of 23 patients with a median age of 14 years and a median Cobb’s angle of 61° were studied. Ventricular and atrial myocardial deformation was measured using speckle tracking echocardiography. The results of the patients were compared with 22 controls. Results: Compared with controls, the patients had a significantly greater annular a velocity (p=0.04) and lower e/a ratio (p=0.03); the left ventricular deformation significantly decreased in radial global (p=0.04) and segmental systolic strain and early diastolic strain rate (p=0.03); the left atrial deformation showed a significantly lower positive strain (p=0.02), greater negative strain (p=0.01), and active contractile strain rate (p=0.01). For the patients, the Cobb’s angle was negatively correlated with the left ventricular global radial systolic strain (r=−0.65, p=0.001), left atrial positive strain (r=−0.68, p<0.001), and the left atrial negative strain was positively correlated with the left ventricular circumferential late diastolic strain rate (r=0.46, p=0.01). The left atrial conduit strain rate was positively correlated with the left ventricular circumferential early diastolic strain rate (r=0.42, p=0.03). The left atrial active contractile strain rate was positively correlated with the left ventricular longitudinal late diastolic strain rate (r=−0.4, p=0.03). Conclusions: Impaired left ventricular and altered left atrial mechanics occur relatively early in patients with congenital scoliosis, and are correlated with the severity of their scoliosis. Our findings provide evidence of preclinical heart dysfunction in patients with this disorder.

Keywords

Congenital scoliosisventricular mechanicsatrial mechanicsinteractionspeckle tracking echocardiography
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 5 , June 2015 , pp. 976 - 983
Copyright
© Cambridge University Press 2014 

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