title: How is the peri-patch myocardium in ventricular septal defect patch repair?
abstract: Strain rate (SR) and strain (≈) in tissue Doppler imaging provide new noninvasive measurements of myocardial function, independent of heart motion. This study assesses the extent of peri-patch regional myocardial function after patch repair of ventricular septal defect (VSD). Myocardial SR and ≈ were recorded from the peri-patch myocardium and remote septum from patch area in 18 patients (1 month to 4 years of age, mean 2.3 years). Distance between the patch and the point of returning to remote normal strain (≈) profile was measured. Compared to the remote myocardial region, peri-patch myocardium had decreased peak longitudinal SR (-3.8 ± 2.1s(-1) vs. -5.3 ± 3.3s(-1), p<0.05), delayed time to peak longitudinal SR (144 ± 59 ms vs. 110 ± 46 ms, p<0.05), decreased peak ≈ (longitudinal, -20.8 ± 8.1% vs. -28.7 ± 11.1%; radial, 20.1 ± 16.3% vs. 34.3 ± 22.4%, p<0.01), and delayed time to peak ≈ (longitudinal, 314 ± 80 ms vs. 241 ± 63 ms; radial, 329 ± 99 ms vs. 265 ± 78 ms, p<0.0001). The mean distance from the patch to the remote patch ɛ curve was 2.55 ± 0.77 mm.
  
  
  CONCLUSIONS
  Peri-patch myocardium after repair of VSD has delayed and diminished contraction as compared to more remote normal myocardium.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Lucy Youngmin
authors.initials: LY
authors.lastname: Eun
authors.forename: Han Ki
authors.initials: HK
authors.lastname: Park
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Choi
mesh_terms: D002675:Child, Preschool; D018618:Echocardiography, Doppler, Color; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009200:Myocardial Contraction / Q000502:physiology*