title: Quantitative analysis of right atrial performance after surgical repair of tetralogy of Fallot.
abstract: We aimed to assess the right atrial performance in patients after surgical correction of tetralogy of Fallot, and to clarify the relationship between the pump function of the right atrium and right ventricular systolic function. We included in the study 50 asymptomatic patients following corrective surgery of tetralogy of Fallot, comparing them to 30 normal subjects. Right atrial areas were measured by echocardiography, and the active fractional area of emptying was expressed, in percentages, as the area measured at the onset of atrial contraction, minus the minimal area, divided by the area at the onset of atrial contraction. We used this value to assess the atrial pump function. Right atrial peak strain rates were measured by tissue Doppler imaging. Compared to controls, patients with tetralogy of Fallot had a significantly reduced right atrial active fractional area of emptying (p = 0.005), along with a reduced peak late diastolic strain rate (p = 0.002). Among 20 patients who underwent magnetic resonance tomographic examination, a relatively higher right atrial peak late diastolic strain rate was shown in patients with a right ventricular ejection fraction of less than 50% (p = 0.021). Right atrial performance is reduced in patients after surgical correction of tetralogy of Fallot. When facing right ventricular systolic dysfunction, nonetheless, the right atrial pump function may be relatively enhanced. Tissue Doppler derived strain rate can provide quantitative analysis of regional right atrial performance.
authors.affiliation: Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University.
authors.forename: Wei
authors.initials: W
authors.lastname: Hui
authors.forename: Mohamed Y
authors.initials: MY
authors.lastname: Abd El Rahman
authors.forename: Fatima
authors.initials: F
authors.lastname: Dsebissowa
authors.forename: Axel
authors.initials: A
authors.lastname: Rentzsch
authors.forename: Matthias
authors.initials: M
authors.lastname: Gutberlet
authors.forename: Vladimir
authors.initials: V
authors.lastname: Alexi-Meskishvili
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
authors.forename: Peter E
authors.initials: PE
authors.lastname: Lange
authors.forename: Hashim
authors.initials: H
authors.lastname: Abdul-Khaliq
mesh_terms: D000293:Adolescent; D000328:Adult; D016275:Atrial Function; D002648:Child; D004452:Echocardiography; D018618:Echocardiography, Doppler, Color; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*; D016278:Ventricular Function, Right / Q000502:physiology