title: Left Ventricular Mechanics in Patients with Abnormal Origin of the Left Main Coronary Artery from the Pulmonary Trunk Late after Successful Repair.
abstract: OBJECTIVE
  Our aim was to evaluate left ventricular (LV) mechanics by using speckle tracking echocardiography (STE) in asymptomatic patients with abnormal origin of the left main coronary artery from the pulmonary trunk (ALCAPA), late after successful repair, in the presence of LV ejection fraction (EF) >50%.
  
  
  METHODS
  We studied 30 ALCAPA patients (median age 4 years, range 1-25 years, NYHA class I, LVEF >50%) and 16 healthy age- and sex-matched controls (median age 5 years, range 1-25 years). All underwent standard echocardiographic evaluation and STE.
  
  
  RESULTS
  LV dimensions and LVEF (63.6 ± 8.2% vs. 64.1 ± 5.1%, p = 0.826) were not different between patients and controls. Diastolic parameters were significantly abnormal in our patients versus controls (E/e' average: 11.9 ± 5.8 vs. 6.6 ± 3.0, p = 0.0014). Global LV longitudinal strain was significantly lower in ALCAPA patients versus controls (-17.6 ± 3.5% vs. -23.4 ± 3.1%, p < 0.0001). LV torsion (9.1 ± 4.9° vs. 11.9 ± 3.3°, p = 0.046) was significantly impaired in ALCAPA patients.
  
  
  CONCLUSIONS
  After successful repair in asymptomatic ALCAPA patients, despite an LVEF >50%, diastolic function, LV longitudinal deformation and LV torsion remain impaired. We suggest including a detailed study of the diastolic function and cardiac mechanics in the clinical follow-up of these patients to identify the subgroup of patients at higher risk.
authors: King Faisal Specialist Hospital and Research Center, Al Faisal University Heart Center, Riyadh, Saudi Arabia.
authors: Giovanni
authors: G
authors: Di Salvo
authors: Ghassan
authors: G
authors: Siblini
authors: Ziad
authors: Z
authors: Issa
authors: Habdan
authors: H
authors: Mohammed
authors: Anas
authors: A
authors: Abu Hazeem
authors: Valeria
authors: V
authors: Pergola
authors: Nisreen
authors: N
authors: Muhanna
authors: Naif
authors: N
authors: Al Qweai
authors: Domenico
authors: D
authors: Galzerano
authors: Bahaa
authors: B
authors: Fadel
authors: Majid
authors: M
authors: Fayyadh
authors: Mansour
authors: M
authors: Joufan
authors: Zohair
authors: Z
authors: Halees
authors: Ziad
authors: Z
authors: Bulbul
mesh_terms: D000293:Adolescent; D000328:Adult; D063748:Bland White Garland Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055815:Young Adult