title: Assessment of inter-atrial, inter-ventricular, and atrio-ventricular interactions in tetralogy of Fallot patients after surgical correction. Insights from two-dimensional speckle tracking and three-dimensional echocardiography.
abstract: BACKGROUND
  We aimed to assess biatrial size and function, interactions on atrial and ventricular levels, and atrio-ventricular coupling in patients after tetralogy of Fallot repair.
  
  
  METHODS
  A total of 34 patients with a mean age of 20.9±9 years, and 35 healthy controls, underwent two-dimensional speckle tracking echocardiography for ventricular and atrial strain measurements and real-time three-dimensional echocardiography to assess ventricular and atrial volumes.
  
  
  RESULTS
  When compared with controls, tetralogy of Fallot patients had significantly reduced right atrial peak atrial longitudinal strain (p<0.01), right atrial peak atrial contraction strain (p<0.01), right atrial ejection fraction (p<0.01), left atrial peak atrial longitudinal strain (p<0.01), left atrial peak atrial contraction strain (p<0.05), and left atrial ejection fraction (p<0.01). In the tetralogy of Fallot group, left ventricular ejection fraction was negatively related to the right ventricular end-systolic volume normalised to body surface area (r=-0.62, p<0.01). An association was found in patients between the right atrial peak longitudinal strain and mean right ventricular strain (r=0.64, p<0.01). In patients, the left atrial peak longitudinal strain correlated negatively with right atrial end-diastolic volume normalised to body surface area (r=-0.67, p<0.01), whereas the left atrial ejection fraction correlated weakly with left ventricular ejection fraction (r=0.41, p<0.05).
  
  
  CONCLUSIONS
  In asymptomatic tetralogy of Fallot patients, biatrial dysfunction exists and can be quantified via two-dimensional speckle tracking echocardiography as well as real-time three-dimensional echocardiography. Different forms of interactions on atrial and ventricular levels are evident among such cohorts.
authors.affiliation: 1Department of Pediatric Cardiology,Saarland University Hospital,Homburg,Germany.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abd El Rahman
authors.affiliation: 1Department of Pediatric Cardiology,Saarland University Hospital,Homburg,Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Raedle-Hurst
authors.affiliation: 1Department of Pediatric Cardiology,Saarland University Hospital,Homburg,Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Rentzsch
authors.affiliation: 3Department of Thoracic and Cardiovascular Surgery,Saarland University Medical Center,Homburg/Saar,Germany.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Schäfers
authors.affiliation: 1Department of Pediatric Cardiology,Saarland University Hospital,Homburg,Germany.
authors.forename: Hashim
authors.initials: H
authors.lastname: Abdul-Khaliq
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D013318:Stroke Volume; D013771:Tetralogy of Fallot / Q000601:surgery*; D016277:Ventricular Function, Left; D055815:Young Adult
keywords: Tetralogy of Fallot; atrial function; real-time three-dimensional echocardiography; two-dimensional echocardiography