Regional right and left ventricular function after the Senning operation: an ultrasonic study of strain rate and strain.
BACKGROUND
Systemic right ventricular dysfunction is a major concern in the follow-up of patients who underwent an atrial redirection procedure for transposition (concordant atrio-ventricular and discordant ventriculo-arterial connections). No good non-invasive method is currently available for quantifying right ventricular function.


OBJECTIVE
We have used ultrasonically based imaging of strain rate and strain to quantify regional deformation in the right ventricle after the Senning operation, comparing properties of regional deformation of the right ventricle with right ventricular ejection fraction as measured using magnetic resonance imaging.


METHODS
In 20 asymptomatic patients who had undergone the Senning procedure, we measured peak systolic strain rate and systolic strain values in the right ventricular free wall, the septum and the left ventricular lateral wall using colour Doppler myocardial imaging, comparing the data with findings obtained in 30 healthy subjects. Global right ventricular ejection fraction was assessed using magnetic resonance imaging.


RESULTS
Properties of deformation of the right ventricular free wall were reduced and homogeneous after the Senning procedure compared to normals, with significantly lower values for peak systolic strain rate and systolic strain (-1.1 +/- 0.4 vs. -2.5 +/- 0.9 s(-1); p < 0.05 and -16 +/- 7% vs. -38 +/- 13%; p < 0.05, respectively). There was a significant correlation between regional longitudinal right ventricular systolic strain values and right ventricular ejection fraction (r = -0.87, p < 0.001). In the septum, peak systolic strain rate was again reduced and homogeneous (-1.2 +/- 0.4 vs. -1.8 +/- 0.5 s(-1); p < 0.05 vs. normals). Also in the left ventricle, the lateral wall peak systolic strain rate and systolic strain values were reduced (-1.5 +/- 0.5 vs. -2.1 +/- 0.9 s(-1); p < 0.05 and -20 +/- 6% vs.-25 +/- 9%; p < 0.05, vs. normals, respectively).


CONCLUSIONS
Properties of regional longitudinal deformation of the systemic right ventricle are reduced after the Senning procedure compared to normal controls, and correlate well with global right ventricular performance. These findings suggest that ultrasonic strain rate and strain imaging could be used in the non-invasive follow-up of ventricular function in these patients.
Eyskens
Benedicte
B
Department of Pediatric Cardiology, University Hospital Gasthuisberg, Leuven, Belgium.
Weidemann
Frank
F
Kowalski
Miroslaw
M
Bogaert
Jan
J
Dymarkowski
Steven
S
Bijnens
Bart
B
Gewillig
Marc
M
Sutherland
George
G
Mertens
Luc
L
D000293:Adolescent; D006348:Cardiac Surgical Procedures; D018618:Echocardiography, Doppler, Color; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology; D011184:Postoperative Period; D016277:Ventricular Function, Left / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*