Impact of surgical correction of tetralogy of fallot on short-term right and left ventricular function as determined by 2-dimensional speckle tracking echocardiography.
Impact of surgical correction of tetralogy of fallot on short-term right and left ventricular function as determined by 2-dimensional speckle tracking echocardiography.
复制标题
法洛四联症手术矫正对二维斑点追踪超声心动图确定的短期右心室和左心室功能的影响。
DOI：
10.1097/md.0000000000004426
复制
发表时间：
2016-08
期刊：
影响因子：
1.6
通讯作者：
Xie M
中科院分区：
文献类型：
--
作者：
Li Y;Wang X;Lv Q;Wang J;Yang Y;He L;Yuan L;Zhang L;Xie M
右心室（RV）和左心室（LV）功能障碍是法洛四联症（TOF）修复患者临床状态不佳的重要决定因素。本研究的目的是通过二维斑点追踪超声心动图（STE）评估手术修复对短期RV和LV功能的影响。研究了67例TOF患者（中位年龄12个月）修复前和修复后6个月以及35例健康受试者。将患者分为年轻（手术时年龄≤12个月）和老年（手术时年龄>12个月）亚组。用STE测量RV和LV整体纵向收缩应变和应变率（SR），以及LV整体周向和径向收缩应变和SR。修复后，年轻患者的RV纵向应变和SR增加，而老年患者的RV纵向SR减少。所有患者的LV变形参数均未发生变化。在多因素分析中，术前RV和LV变形参数较好的患者术后RV和LV应变和SR较好（均P<0.05）。 肺动脉瓣环的手术入路对术后右室和左室收缩功能有预测作用（均P<0.05）。 TOF修复后，在年轻患者中发现了短期RV功能改善，但在老年患者中没有发现，而所有患者的LV功能均无变化。术前右心室和左心室变形指数是术后双心室功能改善的决定性因素。STE是评价先天性心脏病手术后双心室功能的一个有价值的工具。
Right ventricular (RV) and left ventricular (LV) dysfunction is an important determinant of poor clinical status in repaired patients with tetralogy of Fallot (TOF). The purpose of our study is to assess the impact of surgical repair on short-term RV and LV function by 2-dimensional speckle tracking echocardiography (STE). Sixty-seven patients (median age 12 months) with TOF before and 6 months after repair and 35 healthy subjects were studied. The patients were divided into the younger (age at surgery ≤12 months) and older (age at surgery >12 months) subgroups. RV and LV global longitudinal systolic strain and strain rate (SR), and LV global circumferential and radial systolic strain and SR were measured by STE. After repair, RV longitudinal strain and SR increased in the younger patients, whereas RV longitudinal SR was decreased in the older patients. LV deformation parameters were unchanged in all patients. In the multivariate analysis, patients with better RV and LV deformation parameters preoperatively were identified to have better RV and LV strain and SR postoperatively (P < 0.05 for all). The surgical approach of the pulmonary valve ring was predictive of RV and LV systolic function postoperatively (P < 0.05 for all). After TOF repair, short-term RV function improvement is identified in the younger but not in the older patients, whereas LV function is unchanged in all patients. The preoperative RV and LV deformational indices are the determinant of postoperative biventricular function improvement. STE appears to be a valuable tool for assessment of biventricular function after congenital heart disease surgery.