title: Speckle-tracking imaging in patients with Eisenmenger syndrome.
abstract: BACKGROUND
  Adults with Eisenmenger syndrome have a survival advantage over those with idiopathic pulmonary arterial hypertension. Improved survival may result from preservation of right ventricular (RV) function.
  
  
  OBJECTIVE
  To assess left ventricular (LV) and RV remodelling in patients with Eisenmenger syndrome compared to a control population, using speckle-tracking imaging.
  
  
  METHODS
  Adults with Eisenmenger syndrome and healthy controls were enrolled into this prospective two-centre study. Patients with Eisenmenger syndrome with low acoustic windows, irregular heart rhythm or complex congenital heart disease were excluded. Clinical assessment, B-type natriuretic peptide (BNP), 6-minute walk test and echocardiography (including dedicated views to perform offline two-dimensional-speckle-tracking analysis) were performed on inclusion.
  
  
  RESULTS
  Our patient population (n=37; mean age 42.3 ± 17 years) was mostly composed of patients with ventricular septal defect (37.8%) or atrial septal defect (35.1%). Compared with the control population (n=30), patients with Eisenmenger syndrome had reduced global LV longitudinal strain (-17.4 ± 3.5 vs. -22.4 ± 2.3; P<0.001), RV free-wall longitudinal strain (-15.0 ± 4.7 vs. -29.9 ± 6.8; P<0.001) and RV transverse strain (25.8 ± 25.0 vs. 44.5 ± 15.1; P<0.001). Patients with Eisenmenger syndrome also more frequently presented a predominant apical longitudinal and transverse strain profile. Among patients with Eisenmenger syndrome, those with a post-tricuspid shunt presented with reduced global LV longitudinal strain but increased RV transverse strain, compared to patients with pre-tricuspid shunt.
  
  
  CONCLUSIONS
  Patients with Eisenmenger syndrome had impaired longitudinal RV and LV strain, but present a relatively important apical deformation. RV and LV remodelling, as assessed by speckle-tracking imaging, differ between patients with pre- and post-tricuspid shunt.
authors: Cardiology Department, hôpital Pasteur, CHU de Nice, 06002 Nice, France; Faculté de médecine, université de Nice Sophia-Antipolis, 06002 Nice, France. Electronic address: moceri.p@chu-nice.fr.
authors: Pamela
authors: P
authors: Moceri
authors: Cardiology Department, hôpital Haut-Lêveque, CHU de Bordeaux, 33600 Bordeaux, France.
authors: Xavier
authors: X
authors: Iriart
authors: Cardiology Department, hôpital Pasteur, CHU de Nice, 06002 Nice, France.
authors: Priscille
authors: P
authors: Bouvier
authors: Cardiology Department, hôpital Pasteur, CHU de Nice, 06002 Nice, France; Faculté de médecine, université de Nice Sophia-Antipolis, 06002 Nice, France.
authors: Delphine
authors: D
authors: Baudouy
authors: Cardiology Department, hôpital Pasteur, CHU de Nice, 06002 Nice, France; Faculté de médecine, université de Nice Sophia-Antipolis, 06002 Nice, France.
authors: Pierre
authors: P
authors: Gibelin
authors: Cardiology Department, hôpital Pasteur, CHU de Nice, 06002 Nice, France; Faculté de médecine, université de Nice Sophia-Antipolis, 06002 Nice, France.
authors: Redouane
authors: R
authors: Saady
authors: Cardiology Department, hôpital Pasteur, CHU de Nice, 06002 Nice, France.
authors: Jeremy
authors: J
authors: Laïk
authors: Cardiology Department, hôpital Pasteur, CHU de Nice, 06002 Nice, France.
authors: Pierre
authors: P
authors: Cerboni
authors: Cardiology Department, hôpital Haut-Lêveque, CHU de Bordeaux, 33600 Bordeaux, France.
authors: Jean-Benoit
authors: JB
authors: Thambo
authors: Cardiology Department, hôpital Pasteur, CHU de Nice, 06002 Nice, France; Faculté de médecine, université de Nice Sophia-Antipolis, 06002 Nice, France.
authors: Emile
authors: E
authors: Ferrari
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D004541:Eisenmenger Complex / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005602:France; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013314:Stress, Mechanical; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D020257:Ventricular Remodeling
keywords: Cardiopathies congénitales; Congenital heart defects; Echocardiography; Eisenmenger syndrome; Hypertension pulmonaire; Pulmonary hypertension; Speckle-tracking imaging; Syndrome d’Eisenmenger; Échocardiographie