Tissue Doppler imaging and brain natriuretic peptide levels in adults with repaired tetralogy of Fallot.
BACKGROUND
Accurate estimation of right ventricular (RV) function in patients with repaired tetralogy of Fallot (RTOF) is difficult, partly due to the presence of tricuspid regurgitation and pulmonary regurgitation and/or stenosis. The aim of the present study was to evaluate RV systolic and diastolic function of adult asymptomatic patients with RTOF by means of tissue Doppler imaging (TDI) and brain natriuretic peptide (BNP) values.


METHODS
25 adult patients with RTOF and 25 healthy controls were studied. The following echocardiographic measurements were obtained: RV diameter/left ventricular (LV) diameter (RVD/LVD) and systolic (Sa) and diastolic (Ea, Aa) velocities at the RV free wall tricuspid annulus site. Serum BNP levels were measured as well.


RESULTS
Patients with RTOF demonstrated reduced TDI velocities: Sa, 8.16 +/- 1.15 versus 16.43 +/- 1.15 cm/sec (P < .001); Ea, 10.00 +/- 2.18 versus 18.99 +/- 1.00 cm/sec (P < .001); Aa, 5.64 +/- 1.77 vs. 13.69 +/- 0.86 cm/sec (P < .001). Patients with RTOF also had higher BNP levels than controls (85.0 +/- 87.0 vs 5.36 +/- 1.0 pg/mL; P < .001). The increased BNP levels in RTOF patients correlated with the RVD/LVD ratio (r = .521; P < .01).


CONCLUSIONS
Our results indicate that although our cohort of patients was asymptomatic, using TDI and BNP allowed us to easily discriminate them from the healthy controls. The ability of TDI to assess ventricular function even in the presence of valvular lesions, as in RTOF patients, makes it a valuable tool in the investigation and follow-up of these patients.
Brili
Stella
S
Athens Medical School, Hippokration Hospital, Athens, Greece. nalexopolous@hotmail.com
Alexopoulos
Nikolaos
N
Latsios
Georgios
G
Aggeli
Constadina
C
Barbetseas
John
J
Pitsavos
Christos
C
Vyssoulis
Gregory
G
Stefanadis
Christodoulos
C
D000293:Adolescent; D000328:Adult; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013771:Tetralogy of Fallot / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000097:blood* / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control
D020097:Natriuretic Peptide, Brain