The influence of pulmonary regurgitation on regional right ventricular function in children after surgical repair of tetralogy of Fallot.
OBJECTIVE
Pulmonary regurgitation after repair of tetralogy of Fallot (TOF) results in right ventricular (RV) dysfunction with significant late morbidity and mortality. The aim was to assess the influence of pulmonary regurgitation on regional RV function.


RESULTS
In 48 asymptomatic children (age 11.1 +/- 3.3 years) with repair of TOF, peak systolic strain rate (SR) and end-systolic strain (epsilon) were acquired using colour Doppler myocardial imaging. RV indices were quantified by magnetic resonance imaging. Echocardiography and exercise capacity was also performed. Forty complete data sets were analysed. An inverse linear relationship was demonstrated between the degree of pulmonary regurgitation and right ventricle end-systolic epsilon (r = -0.53, P < 0.01) as well as a correlation with peak systolic SR (r = -0.35, P < 0.01). A correlation existed between peak VO(2) and peak systolic SR (r = 0.51, P = 0.001) and end-systolic epsilon (r = 0.33, P < 0.05).


CONCLUSIONS
In asymptomatic children after repair of TOF, pulmonary regurgitation is associated with impaired regional systolic RV deformation indices. Regional strain and SR may be an early indicator of RV dysfunction in patients with post-TOF and pulmonary regurgitation.
Eyskens
Benedicte
B
Department of Paediatric Cardiology, University Hospital Leuven, Herestraat 49, B 3000 Leuven, Belgium. benedicte.eyskens@uzleuven.be
Brown
Stephen C
SC
Claus
Piet
P
Dymarkowski
Steven
S
Gewillig
Marc
M
Bogaert
Jan
J
Mertens
Luc
L
D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D004452:Echocardiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D011665:Pulmonary Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology*; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology*; D016278:Ventricular Function, Right