Longitudinal strain by two-dimensional speckle tracking to assess ventricular function in adults with transposition of the great arteries: Can serial assessment be simplified?
Introduction: Transposition of the great arteries (TGA) is a rare form of congenital heart disease in which most patients reach adulthood. Right ventricular dysfunction is the most severe residual complication in long-term follow-up, both in patients treated by atrial switch and in those with congen...
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| Format: | Article |
| Language: | English |
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Elsevier
2018-09-01
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| Series: | Revista Portuguesa de Cardiologia |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0870255117304390 |
| _version_ | 1811221509581045760 |
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| author | Ana T. Timóteo Luísa M. Branco Sílvia A. Rosa Ana Galrinho Lídia Sousa José A. Oliveira Maria F. Pinto Ana F. Agapito Rui C. Ferreira |
| author_facet | Ana T. Timóteo Luísa M. Branco Sílvia A. Rosa Ana Galrinho Lídia Sousa José A. Oliveira Maria F. Pinto Ana F. Agapito Rui C. Ferreira |
| author_sort | Ana T. Timóteo |
| collection | DOAJ |
| description | Introduction: Transposition of the great arteries (TGA) is a rare form of congenital heart disease in which most patients reach adulthood. Right ventricular dysfunction is the most severe residual complication in long-term follow-up, both in patients treated by atrial switch and in those with congenitally corrected TGA. New echocardiographic tools such as longitudinal strain by two-dimensional (2D) speckle tracking may improve assessment of ventricular function in these patients. Methods and Results: We performed a retrospective analysis of echocardiograms in adult patients with TGA (26 patients with dextro-TGA – 15 treated by atrial switch and six by arterial switch – and five with congenitally corrected TGA) and in a control group of 14 healthy individuals. Right ventricular strain was significantly worse (p<0.001), as was the corresponding annular plane systolic excursion (p=0.010) in atrial switch patients, in comparison to arterial switch patients, while no differences were found in left ventricular parameters. In the overall population, systemic right ventricular parameters were significantly less negative than pulmonary right ventricular parameters, and these were less negative than in controls. Left ventricular parameters were similar across groups, except for pulmonary left ventricular strain, which was worse than in controls (p=0.008) as well as pulmonary right ventricular strain. Conclusions: Assessment of ventricular function in patients with TGA by 2D speckle tracking longitudinal strain is easy and feasible and may be a useful tool for serial follow-up. Of particular note, we found that there is also some degree of ventricular dysfunction even after re-establishment of normal connections. Resumo: Introdução: A Transposição das Grandes Artérias (TGA) é uma cardiopatia congénita rara e a maioria dos doentes atinge a idade adulta. A alteração residual mais grave a longo-prazo é a disfunção ventricular direita (VD), quer em doentes submetidos a switch auricular ou em doentes com TGA congenitamente corrigida (TGAcc). Novas ferramentas ecocardiográficas, como o strain bidimensional por speckle tracking podem facilitar a avaliação da função ventricular nestes doentes. Métodos e resultados: Foi realizada uma análise retrospetiva de ecocardiograma efetuados em adultos com TGA (26 doentes com dextro-TGA - 15 submetidos a switch auricular e seis a switch arterial – e cinco com TGAcc) e num grupo de controlo composto por 14 indivíduos saudáveis. O strain VD foi significativamente pior (p<0,001) bem como o annular plane systolic excursion correspondente (p=0,010) nos doentes com switch auricular, em comparação com dos doentes com switch arterial, sem diferenças na análise do ventrículo esquerdo. Na população total, os parâmetros do VD sistémico foram significativamente menos negativos do que o VD pulmonar e estes menos negativos comparativamente com o grupo controlo. Os parâmetros ventriculares esquerdos foram semelhantes em todos os grupos, exceto o strain do ventrículo esquerdo pulmonar que é pior comparativamente com o controlo (p=0,008) bem como com o VD pulmonar. Conclusões: A avaliação da função ventricular em doentes com TGA por strain longitudinal com speckle tracking bidimensional é fácil e pode ser uma ferramenta útil no seguimento destes doentes. De salientar contudo, que verificámos algum grau de disfunção ventricular mesmo após restabelecimento de conexões normais. Keywords: Transposition of the great arteries, Longitudinal strain, Speckle tracking echocardiography, Palavras-chave: Transposição das grandes artérias, Strain longitudinal, Speckle tracking |
| first_indexed | 2024-04-12T08:00:33Z |
| format | Article |
| id | doaj.art-0233413dd74c46a68bf1c37051c6dbb2 |
| institution | Directory Open Access Journal |
| issn | 0870-2551 |
| language | English |
| last_indexed | 2024-04-12T08:00:33Z |
| publishDate | 2018-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Revista Portuguesa de Cardiologia |
| spelling | doaj.art-0233413dd74c46a68bf1c37051c6dbb22022-12-22T03:41:19ZengElsevierRevista Portuguesa de Cardiologia0870-25512018-09-01379739745Longitudinal strain by two-dimensional speckle tracking to assess ventricular function in adults with transposition of the great arteries: Can serial assessment be simplified?Ana T. Timóteo0Luísa M. Branco1Sílvia A. Rosa2Ana Galrinho3Lídia Sousa4José A. Oliveira5Maria F. Pinto6Ana F. Agapito7Rui C. Ferreira8Cardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Lisboa, Portugal; Corresponding author.Cardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Lisboa, PortugalCardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Lisboa, PortugalCardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Lisboa, PortugalCardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Lisboa, Portugal; Reference Center for Congenital Heart Diseases, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Lisboa, PortugalCardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Lisboa, Portugal; Reference Center for Congenital Heart Diseases, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Lisboa, PortugalReference Center for Congenital Heart Diseases, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Lisboa, PortugalCardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Lisboa, Portugal; Reference Center for Congenital Heart Diseases, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Lisboa, PortugalCardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Lisboa, PortugalIntroduction: Transposition of the great arteries (TGA) is a rare form of congenital heart disease in which most patients reach adulthood. Right ventricular dysfunction is the most severe residual complication in long-term follow-up, both in patients treated by atrial switch and in those with congenitally corrected TGA. New echocardiographic tools such as longitudinal strain by two-dimensional (2D) speckle tracking may improve assessment of ventricular function in these patients. Methods and Results: We performed a retrospective analysis of echocardiograms in adult patients with TGA (26 patients with dextro-TGA – 15 treated by atrial switch and six by arterial switch – and five with congenitally corrected TGA) and in a control group of 14 healthy individuals. Right ventricular strain was significantly worse (p<0.001), as was the corresponding annular plane systolic excursion (p=0.010) in atrial switch patients, in comparison to arterial switch patients, while no differences were found in left ventricular parameters. In the overall population, systemic right ventricular parameters were significantly less negative than pulmonary right ventricular parameters, and these were less negative than in controls. Left ventricular parameters were similar across groups, except for pulmonary left ventricular strain, which was worse than in controls (p=0.008) as well as pulmonary right ventricular strain. Conclusions: Assessment of ventricular function in patients with TGA by 2D speckle tracking longitudinal strain is easy and feasible and may be a useful tool for serial follow-up. Of particular note, we found that there is also some degree of ventricular dysfunction even after re-establishment of normal connections. Resumo: Introdução: A Transposição das Grandes Artérias (TGA) é uma cardiopatia congénita rara e a maioria dos doentes atinge a idade adulta. A alteração residual mais grave a longo-prazo é a disfunção ventricular direita (VD), quer em doentes submetidos a switch auricular ou em doentes com TGA congenitamente corrigida (TGAcc). Novas ferramentas ecocardiográficas, como o strain bidimensional por speckle tracking podem facilitar a avaliação da função ventricular nestes doentes. Métodos e resultados: Foi realizada uma análise retrospetiva de ecocardiograma efetuados em adultos com TGA (26 doentes com dextro-TGA - 15 submetidos a switch auricular e seis a switch arterial – e cinco com TGAcc) e num grupo de controlo composto por 14 indivíduos saudáveis. O strain VD foi significativamente pior (p<0,001) bem como o annular plane systolic excursion correspondente (p=0,010) nos doentes com switch auricular, em comparação com dos doentes com switch arterial, sem diferenças na análise do ventrículo esquerdo. Na população total, os parâmetros do VD sistémico foram significativamente menos negativos do que o VD pulmonar e estes menos negativos comparativamente com o grupo controlo. Os parâmetros ventriculares esquerdos foram semelhantes em todos os grupos, exceto o strain do ventrículo esquerdo pulmonar que é pior comparativamente com o controlo (p=0,008) bem como com o VD pulmonar. Conclusões: A avaliação da função ventricular em doentes com TGA por strain longitudinal com speckle tracking bidimensional é fácil e pode ser uma ferramenta útil no seguimento destes doentes. De salientar contudo, que verificámos algum grau de disfunção ventricular mesmo após restabelecimento de conexões normais. Keywords: Transposition of the great arteries, Longitudinal strain, Speckle tracking echocardiography, Palavras-chave: Transposição das grandes artérias, Strain longitudinal, Speckle trackinghttp://www.sciencedirect.com/science/article/pii/S0870255117304390 |
| spellingShingle | Ana T. Timóteo Luísa M. Branco Sílvia A. Rosa Ana Galrinho Lídia Sousa José A. Oliveira Maria F. Pinto Ana F. Agapito Rui C. Ferreira Longitudinal strain by two-dimensional speckle tracking to assess ventricular function in adults with transposition of the great arteries: Can serial assessment be simplified? Revista Portuguesa de Cardiologia |
| title | Longitudinal strain by two-dimensional speckle tracking to assess ventricular function in adults with transposition of the great arteries: Can serial assessment be simplified? |
| title_full | Longitudinal strain by two-dimensional speckle tracking to assess ventricular function in adults with transposition of the great arteries: Can serial assessment be simplified? |
| title_fullStr | Longitudinal strain by two-dimensional speckle tracking to assess ventricular function in adults with transposition of the great arteries: Can serial assessment be simplified? |
| title_full_unstemmed | Longitudinal strain by two-dimensional speckle tracking to assess ventricular function in adults with transposition of the great arteries: Can serial assessment be simplified? |
| title_short | Longitudinal strain by two-dimensional speckle tracking to assess ventricular function in adults with transposition of the great arteries: Can serial assessment be simplified? |
| title_sort | longitudinal strain by two dimensional speckle tracking to assess ventricular function in adults with transposition of the great arteries can serial assessment be simplified |
| url | http://www.sciencedirect.com/science/article/pii/S0870255117304390 |
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