Myocardial Deformation in Fontan Patients Assessed by Cardiac Magnetic Resonance Feature Tracking: Correlation with Function, Clinical Course, and Biomarkers.

Autor: Callegari A; Division of Pediatric Cardiology, Pediatric Heart Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zürich, Switzerland.; Children's Research Center, Zürich, Switzerland.; University of Zurich, Zürich, Switzerland., Marcora S; Paediatric Cardiology Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy.; Department of Diagnostic Imaging, University Children's Hospital Zurich, Zürich, Switzerland.; Children's Research Center, Zürich, Switzerland., Burkhardt B; Division of Pediatric Cardiology, Pediatric Heart Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zürich, Switzerland.; Department of Diagnostic Imaging, University Children's Hospital Zurich, Zürich, Switzerland.; Children's Research Center, Zürich, Switzerland.; University of Zurich, Zürich, Switzerland., Voutat M; Division of Cardiac Surgery, Pediatric Heart Center, University Children's Hospital Zurich, Zürich, Switzerland.; Children's Research Center, Zürich, Switzerland.; University of Zurich, Zürich, Switzerland., Kellenberger CJ; Department of Diagnostic Imaging, University Children's Hospital Zurich, Zürich, Switzerland.; Children's Research Center, Zürich, Switzerland.; University of Zurich, Zürich, Switzerland., Geiger J; Department of Diagnostic Imaging, University Children's Hospital Zurich, Zürich, Switzerland.; Children's Research Center, Zürich, Switzerland.; University of Zurich, Zürich, Switzerland., Valsangiacomo Buechel ER; Division of Pediatric Cardiology, Pediatric Heart Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zürich, Switzerland. Emanuela.Valsangiacomo@kispi.uzh.ch.; Department of Diagnostic Imaging, University Children's Hospital Zurich, Zürich, Switzerland. Emanuela.Valsangiacomo@kispi.uzh.ch.; Children's Research Center, Zürich, Switzerland. Emanuela.Valsangiacomo@kispi.uzh.ch.; University of Zurich, Zürich, Switzerland. Emanuela.Valsangiacomo@kispi.uzh.ch.
Jazyk: angličtina
Zdroj: Pediatric cardiology [Pediatr Cardiol] 2021 Oct; Vol. 42 (7), pp. 1625-1634. Date of Electronic Publication: 2021 Jul 27.
DOI: 10.1007/s00246-021-02650-w
Abstrakt: Cardiac MR (CMR) is a standard modality for assessing ventricular function of single ventricles. CMR feature-tracking (CMR-FT) is a novel application enabling strain measurement on cine MR images and is used in patients with congenital heart diseases. We sought to assess the feasibility of CMR-FT in Fontan patients and analyze the correlation between CMR-FT strain values and conventional CMR volumetric parameters, clinical findings, and biomarkers. Global circumferential (GCS) and longitudinal (GLS) strain were retrospectively measured by CMR-FT on Steady-State Free Precession cine images. Data regarding post-operative course at Fontan operation, and medication, exercise capacity, invasive hemodynamics, and blood biomarkers at a time interval ± 6 months from CMR were collected. Forty-seven patients underwent CMR 11 ± 6 years after the Fontan operation; age at CMR was 15 ± 7 years. End-diastolic volume (EDV) of the SV was 93 ± 37 ml/m 2 , end-systolic volume (ESV) was 46 ± 23 ml/m 2 , and ejection fraction (EF) was 51 ± 11%. Twenty (42%) patients had a single right ventricle (SRV). In single left ventricle (SLV), GCS was higher (p < 0.001), but GLS was lower (p = 0.04) than in SRV. GCS correlated positively with EDV (p = 0.005), ESV (p < 0.001), and EF (p ≤ 0.0001). GLS correlated positively with EF (p = 0.002), but not with ventricular volumes. Impaired GCS correlated with decreased ventricular function (p = 0.03) and atrioventricular valve regurgitation (p = 0.04) at echocardiography, direct atriopulmonary connection (p = 0.02), post-operative complications (p = 0.05), and presence of a rudimentary ventricle (p = 0.01). A reduced GCS was associated with increased NT-pro-BNP (p = 0.05). Myocardial deformation can be measured by CMR-FT in Fontan patients. SLVs have higher GCS, but lower GLS than SRVs. GCS correlates with ventricular volumes and EF, whereas GLS correlates with EF only. Myocardial deformation shows a relationship with several clinical parameters and NT-pro-BNP.
(© 2021. The Author(s).)
Databáze: MEDLINE
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