Abstract 13566: Right Ventricular Myocardial Deformation: Differences Between Corrected Tetralogy of Fallot and Atrial Septal Defects
Introduction: Due to different underlying mechanisms, patients with tetralogy of Fallot (ToF) and atrial septal defect (ASD) have right ventricular (RV) volume overload.
Objectives: Using speckle-tracking echocardiography, we evaluated regional RV deformation in patients with corrected ToF and those with corrected ASD, and compared both groups with healthy controls.
Methods: Echocardiograms including the standard apical views, were acquired in adult patients with corrected ToF or ASD, and in healthy controls. With speckle-tracking echocardiography, we analyzed longitudinal strain and the strain rate of the RV lateral wall, left ventricular (LV) septum, and LV lateral wall.
Results: We included 166 subjects: 60 with ToF (62% male, age 34.4±8.0 years, age at correction 3.8±3.0 years); 53 with ASD (40% male, age 43.0±5.0 years, age at correction 7.7±3.8 years); and 53 healthy controls (49% male, age 29.7±6.8 years). RV global longitudinal strain of the lateral wall was significantly lower in ToF patients than ASD patients (p=0.02). In both patient groups, RV strain was significantly lower than in controls (p<0.001), due mainly to impaired apical deformation. In controls, the apical segment had the highest strain of all three RV segments; in the patient groups, it had the lowest (Figure 1). ASD and ToF patients also had a significantly lower strain rate of the RV apical segment (p<0.001) than controls (p=0.02). Only in ToF patients was LV global longitudinal strain significantly lower than in controls (p<0.001).
Conclusion: RV longitudinal strain is significantly reduced in corrected ASD patients and even more reduced in ToF patients, particularly in the apical segment. This suggests that apical function is affected most in RV overloaded ventricles.
- © 2013 by American Heart Association, Inc.