Usefulness of right ventricular and right atrial two-dimensional speckle tracking strain to predict late arrhythmic events in adult patients with repaired Tetralogy of Fallot
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- 作者：Ana T. Timó ; teo ; ana_timoteo@yahoo.com ; Luí ; sa M. Branco ; Sí ; lvia A. Rosa ; Ruben Ramos ; Ana F. Agapito ; Lí ; dia Sousa ; Ana Galrinho ; José ; A. Oliveira ; Má ; rio M. Oliveira ; Rui C. Ferreira
- 关键词：Repaired tetralogy of Fallot ; Arrhythmias ; Strain
- 刊名：Revista Portuguesa de Cardiologia (English Edition)
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：36
- 期：1
- 页码：21-29
- 全文大小：694 K
- 卷排序：36
文摘
To determine whether right ventricular and/or atrial speckle tracking strain is associated with previous arrhythmic events in patients with repaired tetralogy of Fallot.Methods and ResultsWe studied right ventricular and atrial strain in 100 consecutive patients with repaired tetralogy of Fallot referred for routine echocardiographic evaluation. Patients were divided into two groups, one with previous documentation of arrhythmias (n=26) and one without arrhythmias, in a median follow-up of 22 years. Patients with arrhythmias were older (p<0.001) and had surgical repair at an older age (p=0.001). They also had significantly reduced right ventricular strain (-14.7±5.5 vs. -16.9±4.0%, p=0.029) and right atrial strain (19.1±7.7% vs. 25.8±11.4%, p=0.001). Neither right ventricular nor right atrial strain were independent predictors of the presence of a history of documented arrhythmias, which was associated with age at correction and with the presence of residual defects. In a subanalysis after excluding 23 patients who had had more than one corrective surgery, right ventricular strain was an independent predictor of the presence of previous arrhythmic events (OR 1.19, 95% CI 1.02-1.38, p=0.025). Right atrial strain was also an independent predictor after adjustment (OR 0.93, 95% CI 0.87-0.99, p=0.029). The ideal cut-off for right ventricular strain was -15.3% and for right atrial strain 23.0%.ConclusionsCompared with conventional echocardiographic parameters, strain measures of the right heart are associated with the presence of arrhythmic events, and may be useful for risk stratification of patients with repaired tetralogy of Fallot, although a prospective study is required.