title: Right ventricular peak systolic longitudinal strain is a sensitive marker for right ventricular deterioration in adult patients with tetralogy of Fallot.
abstract: The aim of this study was to evaluate the feasibility of right ventricular (RV) longitudinal peak systolic strain (LPSS) assessment for the follow-up of adult patients with corrected tetralogy of Fallot (TOF). Adult patients (n = 18) with corrected TOF underwent echocardiography and CMR twice with a time interval of 4.2 +/- 1.7 years. RV performance was derived from CMR, and included RV volumes and ejection fraction (EF). LPSS was calculated globally (GLPSS) and in the RV free wall (LPSS FW), with echocardiographic speckle-tracking strain-analysis. Baseline (G)LPSS values were compared between patients and healthy controls; the relation between (G)LPSS and CMR parameters was evaluated and the changes in (G)LPSS and CMR parameters during follow-up were compared. GLPSS and LPSS FW were significantly reduced in patients as compared to controls (-14.9 +/- 0.7% vs. -21.6 +/- 0.9% and -15.5 +/- 0.9% vs. -22.7 +/- 1.5%, P < 0.01). Moderate agreement between LPSS and CMR parameters was observed. RV EF remained unchanged during follow-up, whereas GLPSS and LPSS FW demonstrated a significant reduction. RVEF showed a 1% increase, whereas GLPSS decreased by 14%, and LPSS FW by 27%. RV LPSS is reduced in TOF patients as compared to controls; during follow-up RV EF remained unchanged whereas LPSS decreased suggesting that RV LPSS may be a sensitive marker to detect early deterioration in RV performance.
authors.affiliation: Department of Cardiology C5-P, Leiden University Medical Centre, Leiden, The Netherlands. r.w.c.scherptong@lumc.nl
authors.forename: Roderick W C
authors.initials: RW
authors.lastname: Scherptong
authors.forename: Sjoerd A
authors.initials: SA
authors.lastname: Mollema
authors.forename: Nico A
authors.initials: NA
authors.lastname: Blom
authors.forename: Lucia J M
authors.initials: LJ
authors.lastname: Kroft
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Hubert W
authors.initials: HW
authors.lastname: Vliegen
authors.forename: Ernst E
authors.initials: EE
authors.lastname: van der Wall
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Eduard R
authors.initials: ER
authors.lastname: Holman
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D018618:Echocardiography, Doppler, Color; D019561:Echocardiography, Four-Dimensional; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D013599:Systole; D013771:Tetralogy of Fallot / Q000150:complications* / Q000503:physiopathology; D013997:Time Factors; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D055815:Young Adult