Evidence of impaired longitudinal strain in pre-Fontan palliation in functional single left ventricle
| Autor: | Alessia Del Pasqua, Marco A Perrone, Marcello Chinali, Gabriele Rinelli, Paolo Guccione, Carolina D'Anna, Priscilla Milewski, Maria Gugliotta, Claudia Esposito, Adriano Carotti, Paolo Ciliberti, Francesco Romeo |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Heart Defects
Congenital Male medicine.medical_specialty Palliative care Heart Ventricles medicine.medical_treatment Population Hemodynamics 030204 cardiovascular system & hematology Fontan Procedure Ventricular Function Left Fontan procedure 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine Ventricular Pressure medicine Humans 030212 general & internal medicine Child education Retrospective Studies Cardiac catheterization education.field_of_study Ejection fraction business.industry Palliative Care Infant Stroke Volume General Medicine Stroke volume Echocardiography Child Preschool Ventricular pressure Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiovascular Medicine. 20:833-836 |
| ISSN: | 1558-2027 |
| DOI: | 10.2459/jcm.0000000000000887 |
| Popis: | Background We evaluated two-dimensional speckle-tracking echocardiography longitudinal strain (L2DSE) in functionally single left ventricles (LV). Methods We retrospectively analyzed 21 patients with functionally single LV. We divided patients into two groups according to pre-Fontan cardiac catheterization data: group 1, adequate data for Fontan procedure and group 2, inadequate data. Results LV strain correlated with predicted pressure in the Fontan system (r = 0.64; P = 0.003), pressure in the Glenn system (r = 0.57; P = 0.010), and transpulmonary gradient (r = 0.59; P = 0.008), but not with left atrial pressure (r = 0.292; P = 0.226) or ejection fraction (r = 0.254; P = 0.294). In multiple regression analysis, four-chamber LV strain was correlated with predicted pressure in the Fontan (β = 0.642: P = 0.003), whereas no association was found with LV ejection fraction (β = 0.254; P = 0.294), or time from Glenn palliation (β = 0.082; P = 0.893). When dividing the population into two groups according to catheterization data, significantly lower four-chamber longitudinal 2DSE (-25.8 ± 3.2 vs.-19.5 ± 5.1; P = 0.004) was found to be not suitable for the Fontan procedure, as compared with those who underwent successful Fontan completion. Conclusion Regardless of ejection fraction, four-chamber L2DSE is associated with high predicted pressure in the Fontan system. Patients with hemodynamic data unsuitable for Fontan operation have significantly lower mean longitudinal strain parameters. 2DSE may represent a valuable tool in assessing patients with single LV physiology and might provide useful pre-Fontan information. |
| Databáze: | OpenAIRE |
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