title: Noninvasive perioperative evaluation of right ventricular function in children with tetralogy of Fallot.
abstract: Early and accurate noninvasive means of identifying right ventricular (RV) dysfunction in children with tetralogy of Fallot (TOF) are needed. RV function was examined using tissue Doppler imaging (TDI), strain rate (SR), and strain analysis (SA) in children before (N = 37) and after (6-12 months; N = 32) TOF repair, and in a control group of children (N = 37). Plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) and matrix metalloproteinase 9 (MMP-9) were measured. TDI, SR, and SA revealed that RV systolic and diastolic function indices were lower preoperatively in the TOF group compared with the control group, and did not improve after TOF repair. Plasma NT-proBNP concentrations were significantly higher in the TOF group pre- and postoperatively compared with the control group. In the preoperative TOF group, NT-proBNP concentration was significantly correlated with peak systolic SR and systolic strain in the mid segments of RV free wall. Plasma MMP-9 concentrations were significantly increased in the preoperative TOF group compared with the control group, and significantly correlated with plasma NT-proBNP and logNT-proBNP concentrations. RV function correlated with plasma NT-proBNP concentrations in children with TOF. Assessment of this noninvasive measure may help identify RV dysfunction in patients with TOF before they become clinically symptomatic.
authors.affiliation: Department of Ultrasonography, The Children's Hospital of Zhejiang University and Zhejiang Key Laboratory for Diagnosis and Therapy of Neonatal Diseases, Hangzhou, China.
authors.forename: Jing-Jing
authors.initials: JJ
authors.lastname: Ye
authors.forename: Qiang
authors.initials: Q
authors.lastname: Shu
authors.forename: Xi-Wang
authors.initials: XW
authors.lastname: Liu
authors.forename: Wei-zhong
authors.initials: WZ
authors.lastname: Gu
authors.forename: Jin
authors.initials: J
authors.lastname: Yu
authors.forename: Guo-ping
authors.initials: GP
authors.lastname: Jiang
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D059035:Perioperative Period; D013771:Tetralogy of Fallot / Q000097:blood / Q000150:complications* / Q000601:surgery; D018497:Ventricular Dysfunction, Right / Q000097:blood / Q000150:complications* / Q000175:diagnosis*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D020780:Matrix Metalloproteinase 9
keywords: Matrix metalloproteinase; N-terminal pro-brain natriuretic peptide; Tetralogy of Fallot; Tissue Doppler imaging; Ventricular function