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Article: Three-dimensional mechanical dyssynchrony and myocardial deformation of the left ventricle in patients with tricuspid atresia after fontan procedure

TitleThree-dimensional mechanical dyssynchrony and myocardial deformation of the left ventricle in patients with tricuspid atresia after fontan procedure
Authors
KeywordsMechanical dyssynchrony
Single ventricle
Three-dimensional echocardiography
Tricuspid atresia
Issue Date2012
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/echo
Citation
Journal Of The American Society Of Echocardiography, 2012, v. 25 n. 4, p. 393-400 How to Cite?
AbstractBackground: The aim of this study was to test the hypothesis that dyssynchronous contraction of functional single ventricles occurs in Fontan patients and is related to indices of myocardial deformation and global ventricular function. Methods: Twenty patients with tricuspid atresia (mean age, 23.5 ± 7.1 years) were studied 17.8 ± 3.8 years after undergoing the Fontan procedure. Three-dimensional echocardiographic data were acquired for determination of left ventricular (LV) volumes and systolic dyssynchrony indices. LV myocardial deformation was determined using speckle-tracking echocardiography. Calibrated integrated backscatter intensity was measured as an index of myocardial fibrosis. The results were compared with those in 20 controls. Results: Compared with controls, patients had significantly greater systolic dyssynchrony indices (6.13 ± 1.32% vs 4.06 ± 0.84%, P <.001). The prevalence of LV mechanical dyssynchrony (systolic dyssynchrony index > 5.74%) in patients was 55% (95% confidence interval, 32%-77%). LV global systolic longitudinal, radial, and circumferential strain (P <.001 for all), longitudinal systolic (P <.001) and early diastolic (P <.001) strain rate, and circumferential systolic (P <.001) and early diastolic (P =.009) strain rate were significantly lower in patients than in controls, while the average calibrated integrated backscatter was higher (P <.001). Patients with LV dyssynchrony (n = 11) had lower global LV longitudinal strain (P =.02), reduced LV ejection fractions (P =.002), and higher average calibrated integrated backscatter (P =.03) compared with those without LV dyssynchrony (n = 9). Conclusions: A high proportion of patients with tricuspid atresia after the Fontan operation exhibit LV mechanical dyssynchrony, which may in part be related to myocardial fibrosis and has implications for myocardial deformation and global ventricular function. © 2012 by the American Society of Echocardiography.
Persistent Identifierhttp://hdl.handle.net/10722/146402
ISSN
2015 Impact Factor: 4.254
2015 SCImago Journal Rankings: 2.808
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorHo, PKen_HK
dc.contributor.authorLai, CTMen_HK
dc.contributor.authorWong, SJen_HK
dc.contributor.authorCheung, YFen_HK
dc.date.accessioned2012-04-24T07:51:49Z-
dc.date.available2012-04-24T07:51:49Z-
dc.date.issued2012en_HK
dc.identifier.citationJournal Of The American Society Of Echocardiography, 2012, v. 25 n. 4, p. 393-400en_HK
dc.identifier.issn0894-7317en_HK
dc.identifier.urihttp://hdl.handle.net/10722/146402-
dc.description.abstractBackground: The aim of this study was to test the hypothesis that dyssynchronous contraction of functional single ventricles occurs in Fontan patients and is related to indices of myocardial deformation and global ventricular function. Methods: Twenty patients with tricuspid atresia (mean age, 23.5 ± 7.1 years) were studied 17.8 ± 3.8 years after undergoing the Fontan procedure. Three-dimensional echocardiographic data were acquired for determination of left ventricular (LV) volumes and systolic dyssynchrony indices. LV myocardial deformation was determined using speckle-tracking echocardiography. Calibrated integrated backscatter intensity was measured as an index of myocardial fibrosis. The results were compared with those in 20 controls. Results: Compared with controls, patients had significantly greater systolic dyssynchrony indices (6.13 ± 1.32% vs 4.06 ± 0.84%, P <.001). The prevalence of LV mechanical dyssynchrony (systolic dyssynchrony index > 5.74%) in patients was 55% (95% confidence interval, 32%-77%). LV global systolic longitudinal, radial, and circumferential strain (P <.001 for all), longitudinal systolic (P <.001) and early diastolic (P <.001) strain rate, and circumferential systolic (P <.001) and early diastolic (P =.009) strain rate were significantly lower in patients than in controls, while the average calibrated integrated backscatter was higher (P <.001). Patients with LV dyssynchrony (n = 11) had lower global LV longitudinal strain (P =.02), reduced LV ejection fractions (P =.002), and higher average calibrated integrated backscatter (P =.03) compared with those without LV dyssynchrony (n = 9). Conclusions: A high proportion of patients with tricuspid atresia after the Fontan operation exhibit LV mechanical dyssynchrony, which may in part be related to myocardial fibrosis and has implications for myocardial deformation and global ventricular function. © 2012 by the American Society of Echocardiography.en_HK
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/echoen_HK
dc.relation.ispartofJournal of the American Society of Echocardiographyen_HK
dc.subjectMechanical dyssynchronyen_HK
dc.subjectSingle ventricleen_HK
dc.subjectThree-dimensional echocardiographyen_HK
dc.subjectTricuspid atresiaen_HK
dc.titleThree-dimensional mechanical dyssynchrony and myocardial deformation of the left ventricle in patients with tricuspid atresia after fontan procedureen_HK
dc.typeArticleen_HK
dc.identifier.emailCheung, YF:xfcheung@hku.hken_HK
dc.identifier.authorityCheung, YF=rp00382en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.echo.2012.01.003en_HK
dc.identifier.pmid22297084-
dc.identifier.scopuseid_2-s2.0-84859155165en_HK
dc.identifier.hkuros199354en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84859155165&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume25en_HK
dc.identifier.issue4en_HK
dc.identifier.spage393en_HK
dc.identifier.epage400en_HK
dc.identifier.isiWOS:000302131900005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridHo, PK=9244016100en_HK
dc.identifier.scopusauthoridLai, CTM=54389305900en_HK
dc.identifier.scopusauthoridWong, SJ=25924109100en_HK
dc.identifier.scopusauthoridCheung, YF=7202111067en_HK

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