Diastolic Dyssynchrony Differences in Patients with Single Right Ventricles vs. Control Patients

Stiver, Corey; Nadorlik, Holly; Nicholson, Lisa; Janevski, Ilija; Belfrage, Katharine; Wheller, John J.; Clifford, L.

doi:10.1111/chd.12234

Cited by 5 publications

(2 citation statements)

References 33 publications

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“…The results showed STE to be more sensitive than conventional echocardiography in detecting an early and progressive decline in the performance of the dominant ventricle [ 18 , 20 , 30 , 31 ]. As such, serial interstage and post-Fontan completion STE assessment may help to early identify ventricular dysfunction and Fontan circulation failure and to allow prompt management of complications [ 18 , 20 , 22 , 23 , 26 , 27 ]. Moreover, pre-and post-operative STE indices were associated with mortality, need for heart transplantation and prolonged hospitalization [ 13 , 28 , 29 , 30 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

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The Role of Myocardial Strain Imaging in the Pre- and Post-Operative Assessment of Patients with Single Ventricle

Kleitsioti¹,

Koulaouzidis²,

Giannakopoulou³

et al. 2023

Rev. Cardiovasc. Med.

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The term “single ventricle” refers to a wide range of cardiac structural and functional abnormalities which cause the morphologically right or left ventricle to be hypoplastic or functionally inadequate. Patients with single-ventricle physiology have followed a series of palliative surgeries, resulting in the dominant ventricle supporting only the systemic circulation and the systemic venous return draining directly to the pulmonary arteries. Such patients present a progressive decline in myocardial performance, and their management is associated with high morbidity, mortality and resource usage. At each management step, imaging is critical in eligibility assessment, pre-procedural planning and prompt detection of myocardial dysfunction. However, the complex and asymmetric geometry of the dominant ventricle and its segmental wall motion abnormalities make the echocardiographic evaluation of myocardial performance in these patients rather challenging. Consequently, conventional 2-dimensional echo functional parameters, such as ejection fraction by Simpson’s biplane method or shortening fraction by M-mode, is complex and often not feasible to apply. On the other hand, speckle-tracking echocardiography is angle and geometry independent and has better reproducibility. As such, it constitutes an appealing method for assessing myocardial function in patients with single-ventricle hearts. Therefore, this review aims to investigate the role of myocardial strain imaging by speckle-tracking echocardiography in the pre-and post-operative assessment of patients with single-ventricle hearts.

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Section: Discussionmentioning

confidence: 99%

“…Lastly, Stiver et al . [ 26 ] examined diastolic dyssynchrony in 35 HLHS children who had undergone Fontan completion and compared them with 25 children with normal hearts (Table 1 ). The time interval from the onset of QRS to the peak early diastolic strain rate (SRe) was obtained for the six RV segments.…”

Section: Ventricular Function Assessment By Stementioning

confidence: 99%

The Role of Myocardial Strain Imaging in the Pre- and Post-Operative Assessment of Patients with Single Ventricle

Kleitsioti¹,

Koulaouzidis²,

Giannakopoulou³

et al. 2023

Rev. Cardiovasc. Med.

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Decline of Systolic and Diastolic 2D Strain Rate During Follow-Up of HLHS Patients After Fontan Palliation

et al. 2016

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Accurate assessment of ventricular function is particularly important in children with hypoplastic left heart syndrome (HLHS) after completion of the total cavopulmonary connection (TCPC). For this purpose, two-dimensional speckle tracking (2DST) is a promising technique as it does not depend on the angle of insonation or the geometry of the ventricle. The objective of this study was to assess changes in systolic and diastolic right ventricular (RV) function within a 5-year follow-up period of HLHS patients after TCPC using conventional and 2DST echocardiography. RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), E/A, E/e' and 2DST parameters [global longitudinal peak systolic strain (GS) and strain rate (GSRs), global strain rate in early (GSRe) and late (GSRa) diastole] of 40 HLHS patients were compared at 1.6 and at 5.1 years after TCPC. RVFAC, E/A, E/e' and GS did not change, whereas TAPSE (13.7 ± 3.2 vs. 10.5 ± 2.4 mm/m(2), p < 0.001), GSRs (-1.56 ± 0.28 vs. -1.35 ± 0.31 1/s, p < 0.001), GSRe (2.22 ± 0.49 vs. 1.96 ± 0.44 1/s, p = 0.004) and GSRa (1.19 ± 0.39 vs. 0.92 ± 0.39 1/s, p < 0.001) decreased significantly. Systolic and diastolic RV function parameters of HLHS patients decreased from 1.6 to 5.1 years after TCPC in our patients. Changes in global strain rate parameters may be signaling early RV dysfunction that is not detectable by traditional echocardiography. Further study is needed to verify this and to determine whether these changes are clinically relevant.

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Update of How Pediatric Cardiologists Noninvasively Evaluate Patients with Hypoplastic Left Heart Syndrome: 2013 vs. 2023

Onorato,

Fleishman,

Nadorlik

et al. 2024

Pediatr Cardiol

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Diastolic Dyssynchrony Differences in Patients with Single Right Ventricles vs. Control Patients

Abstract: Patients with HLHS had increased diastolic dyssynchrony compared with control patients as measured via deformation analysis. Future studies are needed to determine the significance of these findings.

Cited by 5 publications

References 33 publications

The Role of Myocardial Strain Imaging in the Pre- and Post-Operative Assessment of Patients with Single Ventricle

The Role of Myocardial Strain Imaging in the Pre- and Post-Operative Assessment of Patients with Single Ventricle

Decline of Systolic and Diastolic 2D Strain Rate During Follow-Up of HLHS Patients After Fontan Palliation

Update of How Pediatric Cardiologists Noninvasively Evaluate Patients with Hypoplastic Left Heart Syndrome: 2013 vs. 2023

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