Background Functional single ventricle (FSV) is a spectrum of severe congenital heart disease, with multiple anatomic variations but similar surgical treatment strategies. FSV patients are living longer into adulthood compared to two or three decades ago, and they are more frequently undergoing imaging to assist in clinical and surgical management. Objective To determine impact of ventricular morphology on myocardial deformation in patients with single ventricle. Material and Methods From November 2017 to July 2018, 41 patients with single ventricle morphology or Physiology who were referred to Ain-Shams University hospitals for follow up Echocardiography or diagnostic cardiac catheterization were enrolled in the study.All patients subjected to history, clinical examination Echocardiography (conventional 2D and speckle tracking “global longitudinal strain and strain rate”.Dominant ventricular strain was analyzed using conventional two-dimensional echocardiographic. The region of interest was obtained by tracing the dominant ventricle endocardial borders at end-systole. An automated software program was used to calculate the frame-to-frame displacements of speckle pattern within the region of interest throughout the cardiac cycle. Results There is statiscially significance between the basic anatomy of the single ventricle and the ejection fraction (p value 0.001) and global longitudinal strain pattern by speckle tracking echocardiography with (p value 0.031) with no statistically effect of the side of dominance. Conclusion: Regarding the side of dominant ventricle there is no significant relation between the side of dominant ventricle on myocardial deformation (by ejection fraction, global strain and strain rate by speckle tracking echocardiography) but there is significant relation between the ventricular morphology and the myocardial deformation that was assessed by by the ejection fraction and global longitudinal strain (by speckle tracking echocardiography) but with no significant effect on the strain rate (by speckle tracking echocardiography)
Background Cardiac resynchronization therapy (CRT) is a standard treatment in patients with heart failure; however, approximately 20–40% of recipients of (CRT) do not respond to it based on the current patients’ selection criteria. The purpose of this study was to identify the baseline parameters that predict the CRT response and how the ECG morphology can affect the outcome. The study aimed to evaluate the Strauss ECG criteria as a predictor of response in patients undergoing cardiac resynchronization therapy. Results Out of 70 patients, 3 patients missed the 6-month follow-up after CRT implantation, so the study enrolled 67 patients that have been classified according to ECG morphology of LBBB to 37 patients with non-Strauss ECG criteria—one of whom died after 4 months—and 30 patients with Strauss ECG criteria. The number of responders in the study was 50 patients with percentage 75.8%; 52% of CRT responder (26 patients) had non-Strauss ECG criteria, while 48% of CRT responders (24 patients) had Strauss ECG criteria with P value = 0.463. While there was no statistical significance of overall CRT response nor 6-month hospitalization and mortality between patients of Strauss and non-Strauss ECG criteria, there was a significant improvement in NYHA class, EF assessed by biplane Simpson’s, end-systolic volume, global longitudinal strain and global circumferential strain by speckle tracking echocardiography in patients with Strauss ECG criteria of LBBB. Conclusions There is no statistical significance in overall CRT response nor the 6-month hospitalization and mortality after 6 months of follow-up between patients with Strauss and non-Strauss ECG criteria of LBBB; however, patients with Strauss ECG criteria have better improvement in NYHA class, echocardiographic parameters such as EF and ESV and speckle tracking parameters (GLS and GCS).
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