title: Comparison of longitudinal myocardial deformation and dyssynchrony in children with left and right ventricular morphology after the Fontan operation using two-dimensional speckle tracking.
abstract: OBJECTIVE
  Two-dimensional speckle tracking can assess ventricular deformation independent of ventricular geometry. Using this technique, the aim of our study was therefore to compare global and regional longitudinal deformation and intraventricular dyssynchrony between children with left and right ventricular morphology after Fontan operation.
  
  
  METHODS
  In this retrospective study, we examined 29 children with systemic right (group 1: age 7.7 ± 2.7 years, time after Fontan 5.3 ± 3.0 years) and 22 children with systemic left (group 2: age 7.8 ± 4.8 years, time after Fontan 4.6 ± 4.2 years) ventricles after Fontan surgery using two-dimensional speckle tracking. We compared global and regional longitudinal strain and strain rate (SR) as well as time to peak strain in basal lateral and septal segments.
  
  
  RESULTS
  Global strain (-18.5 ± 3.5 vs. -17.9 ± 3.2%, P= NS) and global SR (-1.0 ± 0.2 vs. -1.0 ± 0.2/s, P= NS) did not differ between groups. Regional strain (-8.7 ± 8.6 vs. -14.7 ± 6.7%, P= .008) and SR (-0.7 ± 0.4 vs. -1.0 ± 0.3%, P= .002) in the basal septal segment were lower in group 1, while regional strain was higher in group 1 in the apical septal segment (-23.5 ± 8.0 vs. -18.4 ± 5.9%, P= .02). Time to peak strain was higher in the basal septal segment in group 1 (410 ± 78 vs. 338 ± 90 ms, P= .004) but not different in the basal lateral segment.
  
  
  CONCLUSIONS
  Despite minor regional differences in longitudinal deformation and dyssynchrony, overall ventricular longitudinal deformation was not different between morphologic right and left ventricles. These findings may reflect similar adaptation of longitudinal function of both ventricular morphologies to the single-ventricle circulation in our cohort, albeit relatively early after Fontan surgery.
authors.affiliation: Departments of Congenital Heart Disease and Pediatric Cardiology, Cardiac and Vascular Surgery, University Hospital of Schleswig-Holstein, Schanenweg 20, Kiel, Germany. Petko@pedcard.uni-kiel.de
authors.forename: Colin
authors.initials: C
authors.lastname: Petko
authors.forename: Jan Hinnerk
authors.initials: JH
authors.lastname: Hansen
authors.forename: Jens
authors.initials: J
authors.lastname: Scheewe
authors.forename: Carsten
authors.initials: C
authors.lastname: Rickers
authors.forename: Hans-Heiner
authors.initials: HH
authors.lastname: Kramer
mesh_terms: D000222:Adaptation, Physiological; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D018729:Fontan Procedure; D005858:Germany; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right