Usefulness of strain cardiac magnetic resonance for the exposure of mild left ventricular systolic abnormalities in pectus excavatum
| Autor: | Juan Maria Farina, Gaston A. Rodriguez-Granillo, Maxroxia Valle-Anziani, Marcelo Martinez-Ferro, Ines Bordoli, Lucia Fontana, Pablo Diluca, Luzia Toselli, Ignacio M. Raggio, Gaston Bellia-Munzon |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Heart Defects Congenital medicine.medical_specialty Magnetic Resonance Spectroscopy Adolescent Heart Ventricles Ventricular Dysfunction Left Young Adult Pectus excavatum Internal medicine medicine Humans Expiration Child Stroke Cardiac imaging Ejection fraction medicine.diagnostic_test business.industry Magnetic resonance imaging Stroke Volume General Medicine medicine.disease medicine.anatomical_structure Ventricle Funnel Chest Pediatrics Perinatology and Child Health Cardiology Ventricular Function Right Population study Surgery business |
| Zdroj: | Journal of pediatric surgery. 57(10) |
| ISSN: | 1531-5037 |
| Popis: | Background Systolic dysfunction in pectus excavatum (PEX) is usually very subtle and mainly focused on the right ventricle (RV), leading to normal or unremarkable cardiac imaging findings unless involving exercise stress. Objectives We evaluated systolic function in PEX using longitudinal strain cardiac magnetic resonance (CMR), a validated parameter for the assessment of the systolic deformation of subendocardial fibers. Methods This prospective registry comprised consecutive patients with PEX who were referred to CMR to define treatment strategies or to establish surgical candidacy. We also included a control group of 15 healthy volunteers without chest wall abnormalities. Using dedicated software, we evaluated the endocardial global longitudinal strain (GLS) of both ventricles and the endocardial global circumferential strain (GCS) of the left ventricle (LV). Results A total of 50 patients with PEX comprised the study population, with a mean age of 19.9 ± 8.0 years. The right ventricular ejection fraction (RVEF) of patients with PEX was significantly lower compared to the control group both at end-expiration (59.5 ± 6.8 vs. 64.7 ± 4.7%, p = 0.008) and end-inspiration (56.7 ± 7.2%, vs. 62.7 ± 4.4, p = 0.004); as well as the pulmonary stroke distance (12.6 ± 2.5, vs. 15.0 ± 2.0 cm, p = 0.001). The LV volumetric analysis revealed no differences between PEX and the control group (p > 0.05 for all) regardless of the respiratory cycle, with a mean expiratory LV ejection fraction (LVEF) of 61.4 ± 6.0%. In contrast, the GLS of the LV was significantly lower in PEX compared to controls (-21.2 ± 3.2 vs. -23.7 ± 3.0%, p = 0.010), whereas GCS was similar either at expiration (-28.5 ± 4.0%, vs. -29.5 ± 2.8, p = 0.38) or inspiration (-29.3 ± 4.1%, vs.-28.9 ± 2.3, p = 0.73). Conclusions In this study, we demonstrated that longitudinal strain analysis might enable the detection of very subtle left ventricular systolic function abnormalities in patients with PEX, that are commonly overlooked using the conventional assessment. Level of evidence II |
| Databáze: | OpenAIRE |
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