title: Mechanisms of Left Ventricular Dysfunction Assessed by Layer-Specific Strain Analysis in Patients With Repaired Tetralogy of Fallot.
abstract: Left ventricular (LV) dysfunction in patients with repaired tetralogy of Fallot (rTOF) is an important risk factor for adverse outcomes. The aim of this study was to assess the details and time course of such LV dysfunction using layer-specific strain analysis by echocardiography.
  
  
  
  The 66 patients with rTOF (mean age, 16.3±9.3 years) were divided into 3 groups (T1: 4-10 years, T2: 11-20 years, T3: 21-43 years), and 113 controls of similar age (mean age, 17.2±9.3 years) were divided into 3 corresponding groups (C1, C2, and C3). Layer-specific longitudinal strain (LS) and circumferential strain (CS) of 3 myocardial layers (endocardial, midmyocardial, and epicardial) were determined by echocardiography. Basal and papillary endocardial CS values were decreased in T1 compared with C1. With the exception of papillary epicardial CS, basal/papillary CS and LS of all 3 layers decreased in T2 compared with C2. Excepting papillary epicardial CS, all other values were decreased in T3 compared with C3.
  
  
  
  Potential myocardial damage was found in the endocardium at the basal and papillary levels of the LV in young patients with rTOF, extending from the endocardium to the epicardium and from the base to the apex. This is the possible time course of LV dysfunction in patients with rTOF.
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine.
authors.forename: Mariko
authors.initials: M
authors.lastname: Yamada
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine.
authors.forename: Ken
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine.
authors.forename: Maki
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine.
authors.forename: Kana
authors.initials: K
authors.lastname: Yazaki
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine.
authors.forename: Hirobumi
authors.initials: H
authors.lastname: Takayasu
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Akimoto
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kishiro
authors.affiliation: Department of Pediatric Cardiology, Sakakibara Heart Institute.
authors.forename: Akio
authors.initials: A
authors.lastname: Inage
authors.affiliation: Department of Pediatric Cardiology, Sakakibara Heart Institute.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Yoshikawa
authors.affiliation: Department of Pediatric Cardiology, Tokyo Women's Medical University.
authors.forename: In-Sam
authors.initials: IS
authors.lastname: Park
authors.affiliation: Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nakanishi
authors.affiliation: Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine.
authors.forename: Shiori
authors.initials: S
authors.lastname: Kawasaki
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shimizu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D009206:Myocardium; D011446:Prospective Studies; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology
keywords: Echocardiography; Layer-specific strain; Myocardial deformation; Tetralogy of Fallot