Left and Right Ventricular Diastolic Function in Adults With Surgically Repaired Tetralogy of Fallot: A Multi-institutional Study
Left and Right Ventricular Diastolic Function in Adults With Surgically Repaired Tetralogy of Fallot: A Multi-institutional Study
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DOI：
10.1016/j.cjca.2012.11.003
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发表时间：
2013-07-01
影响因子：
6.2
通讯作者：
Broberg, Craig S.
中科院分区：
文献类型：
--
作者：
Aboulhosn, Jamil A.;Lluri, Gentian;Broberg, Craig S.
背景：我们的目的是评估法洛四联症(TOF)修补术患者左、右室舒张功能不全(DD)的发生率及其临床意义。超声心动图检查发现325例患者有足够的超声心动图评价左室舒张功能，定义为二尖瓣侧壁E‘/lt；10 cm/S，E/e’/gt；9。右室舒张期功能异常定义为三尖瓣E/A=0.8~2.1，E/e‘=6或E/A+gt；2.1，减速时间<lt；结果：左心室舒张期多普勒指数异常发生率为13.8%，与高血压、血脂异常、3次或3次以上心脏手术、室性心动过速病史相关。RV指数异常率为52.4%，与高血压、血脂异常、糖尿病、3次或3次以上心脏手术有关。室性心动过速在右室舒张期功能异常的患者中更为常见。结论：需要进一步的前瞻性研究来评估这些与DD的相关性，以及治疗危险因素对舒张期功能和心律失常负荷的影响。
Background: Our purpose was to assess the prevalence and clinical implications of left ventricular (LV) and right ventricular (RV) diastolic dysfunction (DD) in patients with repaired tetralogy of Fallot (TOF).Methods: Adults with repaired TOF at 11 North American congenital heart disease centres were included. Of 556 patients analyzed, 325 had sufficient Doppler data to evaluate for LV DD, defined as mitral lateral e' < 10 cm/s and E/e' ratio > 9. Abnormal RV diastolic function was defined as tricuspid E/A ratio of 0.8 to 2.1 with E/e' ratio > 6 or a tricuspid ratio E/A > 2.1 with a deceleration time < 120 milliseconds, and 105 patients were found to have sufficient Doppler data.Results: Abnormal LV diastolic Doppler indices were prevalent in 13.8% and associated with hypertension, dyslipidemia, 3 or more cardiac operations, and a history of ventricular tachycardia. Abnormal RV indices were prevalent in 52.4% and associated with hypertension, dyslipidemia, diabetes mellitus, and 3 or more cardiac operations. Ventricular tachycardia was more common in those with abnormal RV diastolic function.Conclusion: Further prospective studies are needed to evaluate these associations with DD and the impact of treatment risk factors on diastolic function and arrhythmia burden.