| Autor: |
Meyers, Brett A, Bhattacharya, Sayantan, Brindise, Melissa, Loke, Yue-Hin, Payne, Ronald M, Vlachos, Pavlos |
| Zdroj: |
Circulation (Ovid); November 2022, Vol. 146 Issue: Supplement 1 pA14787-A14787, 1p |
| Abstrakt: |
Introduction:Echo-based ventricular flow and biomechanical analysis provides novel measurements of SV function that can be assessed serially. However, this analysis has not been applied to clinical studies. This study demonstrates a new workflow to measure ventricular flow and biomechanics from apical 4-chamber imaging for hypoplastic left heart syndrome [HLHS] patients and age-matched controls.Methods:We retrospectively collected echos at 33 weeks gestation prenatally and 7 days post-birth postnatally. Color Doppler echo of the LV/RV were evaluated using an in-house vector flow reconstruction algorithm, quantifying energy loss [EL] and vortex strength [VS]. B-mode echo of the LV/RV were evaluated for parameters including cardiac output [CO] and global longitudinal strain [GLS].Results:9 HLHS subjects and 11 age-matched controls were included. Prenatal HLHS patients exhibited elevated CO, EL, and VS (p<0.01) but proportional GLS compared to the control LV/RV. The parameters serially increased postnatally (p<0.01), consistent with transitional physiology. GLS in HLHS was differentiable from the normal RV only in postnatal studies, resembling normal LV values.Conclusions:Altered ventricular flow and biomechanics were observed for HLHS patients compared to controls during early life. These novel parameters can be serially evaluated using conventional echo imaging. We will perform longitudinal studies of this HLHS cohort as they progress through surgical palliation to fully understand how our integrated workflow can better inform SV patient care.Figure 1: Left – Comparison of ventricular flow and biomechanical markers between HLHS and control subjects, for prenatal (fetal) and postnatal (neonatal) ages. Right – Ventricular flow patterns for HLHS and control subjects for different ages. |
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