Serial cardiovascular magnetic resonance feature tracking indicates early worsening of cardiac function in Fontan patients.

Autor: Meyer SL; Center for Congenital Heart Diseases, Department of Pediatric Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Center for Congenital Heart Diseases, Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: s.l.meyer@umcg.nl., Ridderbos FS; Center for Congenital Heart Diseases, Department of Pediatric Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Wolff D; Center for Congenital Heart Diseases, Department of Pediatric Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Eshuis G; Center for Congenital Heart Diseases, Department of Pediatric Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., van Melle JP; Center for Congenital Heart Diseases, Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Ebels T; Center for Congenital Heart Diseases, Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Berger RMF; Center for Congenital Heart Diseases, Department of Pediatric Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Willems TP; Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2020 Mar 15; Vol. 303, pp. 23-29. Date of Electronic Publication: 2019 Dec 24.
DOI: 10.1016/j.ijcard.2019.12.041
Abstrakt: Background: In Fontan patients, attrition of ventricular function is well recognized, but early detection of ventricular dysfunction is difficult. The aim of this study is to longitudinally assess ventricular strain in Fontan patients using a new method for cardiac magnetic resonance (CMR) feature tracking, and to investigate the relationship between ventricular strain and cardiac systolic function.
Methods and Results: In this prospective, standardized follow-up study in 51 Fontan patients, age ≥ 10 years, CMR and concomitant clinical assessment was done at the start of the study and after 2 years. CMR feature tracking was done combining the dominant and hypoplastic ventricles. Global longitudinal strain (GLS) (-17.3% versus -15.9%, P = 0.041) and global circumferential strain (GCS) (-17.7 versus -16.1, P = 0.047) decreased over 2 years' time. Ejection fraction (EF) (57%), cardiac index (CI) (2.7 l/min/m 2 ) and NYHA functional class (97% in class I/II) were preserved. The strain values of the combined dominant and hypoplastic ventricles were significantly worse compared to those of the dominant ventricle only (GLS -16.8 (-19.5 to -14.0) versus -18.8 (-21.3 to -15.3) respectively, P = 0.001, GCS -18.3 (-22.1 to -14.8) versus -22.5 (-26.3 to -19.4) respectively, P < 0.001).
Conclusions: This study showed a decrease in cardiac strain over 2 years in Fontan patients without clinical signs of Fontan failure, where EF, CI and clinical status were still preserved. Cardiac strain might be a sensitive early indicator of systolic ventricular decline. Furthermore, combined strain of the hypoplastic and dominant ventricles seems a more accurate representation of cardiac strain in functionally univentricular hearts.
(Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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