title: Two-dimensional right ventricular strain by speckle tracking for assessment of longitudinal right ventricular function after paediatric congenital heart disease surgery.
abstract: BACKGROUND
  Right ventricular (RV) function is a prognostic marker of cardiac disease in children. Speckle tracking has been developed to assess RV longitudinal shortening, the dominant deformation during systole; little is known about its feasibility in children with congenital heart disease (CHD).
  
  
  OBJECTIVE
  To evaluate the feasibility and reproducibility of RV two-dimensional (2D) strain assessed by speckle tracking in infants undergoing CHD surgery compared with conventional markers.
  
  
  METHODS
  In this prospective single-centre study, RV peak systolic strain (RV-PSS) was measured using 2D speckle tracking in 37 consecutive children undergoing CHD surgery. Examinations were performed the day before surgery, a few hours after surgery and before discharge. Relationships with the z score of tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (TA Sa) were assessed.
  
  
  RESULTS
  Median (interquartile range) age was 19 months (5-63); median weight was 9.2 kg (5.3-18.0). RV-PSS analysis was feasible in 92.9% (95% confidence interval [CI]: 86.0-97.1) of examinations. The coefficient of variation was 9.7% (95% CI: 7.4-11.9) for intraobserver variability and 15.1% (95% CI: 12.7-17.6) for interobserver variability. Correlations between RV-PSS and z score of TAPSE and TA Sa were strong (r=0.71, P<0.0001 and r=0.70, P<0.0001, respectively). RV-PSS was significantly reduced after surgery compared with baseline (-10.5±2.9% vs. -19.5±4.8%; P<0.0001) and at discharge (-13.5±4.0% vs. -19.5±4.8%; P<0.0001). Similar evolutions were observed with TAPSE and TA Sa (both P<0.0001).
  
  
  CONCLUSIONS
  RV longitudinal strain by speckle tracking is a feasible and reproducible method of assessing perioperative evolution of RV function in children with CHD.
authors.affiliation: Paediatric Cardiology Unit, Children's Hospital, CHU Toulouse, 31300 Toulouse, France; Intensive Care Unit, Children's Hospital, CHU Toulouse, 31300 Toulouse, France. Electronic address: clement.karsenty@hotmail.fr.
authors.forename: Clement
authors.initials: C
authors.lastname: Karsenty
authors.affiliation: Paediatric Cardiology Unit, Children's Hospital, CHU Toulouse, 31300 Toulouse, France.
authors.forename: Khaled
authors.initials: K
authors.lastname: Hadeed
authors.affiliation: Paediatric Cardiology Unit, Children's Hospital, CHU Toulouse, 31300 Toulouse, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Dulac
authors.affiliation: Paediatric Cardiology Unit, Children's Hospital, CHU Toulouse, 31300 Toulouse, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Semet
authors.affiliation: Department of Congenital Heart Disease Surgery, Children's Hospital, CHU Toulouse, 31300 Toulouse, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Alacoque
authors.affiliation: Intensive Care Unit, Children's Hospital, CHU Toulouse, 31300 Toulouse, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Breinig
authors.affiliation: Department of Congenital Heart Disease Surgery, Children's Hospital, CHU Toulouse, 31300 Toulouse, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Leobon
authors.affiliation: Paediatric Cardiology Unit, Children's Hospital, CHU Toulouse, 31300 Toulouse, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Acar
authors.affiliation: Paediatric Cardiology Unit, Children's Hospital, CHU Toulouse, 31300 Toulouse, France; INSERM UMR1048, Institut des Maladies Métaboliques et Cardiovasculaires, I2MC, Équipe 8, 31300 Toulouse, France; Pôle de Chirurgie des Cardiopathies Congénitales, M3C, Hôpital Marie-Lannelongue, 31300 Le Plessis-Robinson, France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Hascoet
mesh_terms: D000293:Adolescent; D000367:Age Factors; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005602:France; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right
keywords: Cardiopathie congénitale; Congenital heart disease; Fonction ventriculaire droite; Right ventricular function; Speckle tracking; Strain