Abstract 5777: Right Ventricular Strain is a Sensitive Marker for Right Ventricular Deterioration in Adult Patients with Tetralogy of Fallot
Intoduction - Right ventricular (RV) strain was recently proposed as a follow-up parameter for RV function in patients with tetralogy of Fallot (TOF). In this study, RV strain in patients with TOF was compared to RV strain in healthy controls. Furthermore we investigated how changes in RV function, measured during follow-up with cardiac magnetic resonance imaging (MR), are reflected in changes in RV strain.
Methods -18 Asymptomatic patients with TOF (age 33.9 ± 11.2 yrs) were included. To obtain a baseline and follow-up measurement of RV function, 2 echocardiograms that were made during regular outpatient clinic visits (interval 4.2 ± 1.7 yrs) were paired to 2 MR scans. Baseline echocardiographic measurements were compared to that of 18 matched healthy controls. Changes in RV strain during follow-up were compared to changes in MR derived ejection fraction (EF). RV longitudinal strain was analyzed echocardiograpically in the apical 4-chamber view with 2D speckle tracking imaging.
Results - In patients with TOF, RV strain was significantly lower as compared to healthy controls (−14.5 ± 3.4% vs. −21.6 ± 3.9%; P<0.01). RV strain was significantly correlated to RV end diastolic volume (r=0.61; P<0.007) and EF (r=0.80; P<0.001). Moreover, whereas RV EF remained stable over time (43 ± 9% vs. 44 ± 10%; P=0.78), RV strain demonstrated a significant reduction (−14.9 ± 2.8% vs. −12.9 ± 3.7%; P=0.001), see figure⇓.
Conclusion - Adult patients with TOF have lower RV strain values as compared to healthy controls. Furthermore, whereas RV EF remained stable, RV strain was subject to a reduction over time, suggesting that RV strain is a sensitive marker for RV deterioration.