Author + information
Background: Patients are commonly affected by ventricular dysfunction after Fontan palliation. Reliable quantification of ventricular function was hampered by complex ventricular anatomy and physiology. Cine-based feature tracking strain (FTS) is a new technique to assess cardiac function from cardiac magnetic resonance (CMR). The objective of this study was to investigate into FTS in single right ventricle subjects after Fontan palliation undergoing CMR.
Methods: Right ventricular end-diastolic and end-systolic volumes (SVEDV and SVESV), stroke volume (SV), and ejection fraction (EF) were measured offline (Medis QMass advanced edition, the Netherlands) as conventional function parameters. Offline global longitudinal and circumferential strain/SR (GLS/GLSR and GCS/GCSR), and radial strain/SR were performed (TomTec Image Arena, Germany) using FTS. As well, anterior to posterior wall motion delay (<130ms; APWMD) analysis was calculated on the short-axis view at the basal level, and bilateral wall motion delay (<90ms; BLWMD) on the 4-chamber view at the basal and mid levels.
Results: 25 Fontan subjects with right ventricular morphology (mean age 18.4+/-9.6 years, post Fontan period 15.3+/-8.4 years) underwent a CMR study. Basal GCS/GCSR (-11+/-9 %, −0.8+/-0.5 1-s) were lower than it at the mid (-17+/-6 %, −1.1+/-0.5 1-s; p=0.02) and apical (-26+/-9 %, −1.9+/-1.0 1-s; p=0.001 and 0.003) levels. Basal GCS/GCSR were correlated with grade of atrioventricular valvular regurgitation (mild; r=0.53, moderate; r=0.63, severe; r=0.65). There were correlations between GLS/GLSR and GCS/GCSR, and SVEDV (r=0.53 to 0.71). At the mid and apical levels, there were correlations between GCS/GCSR and SVESV, and EF (r=0.68 to 0.79 and r=0.51 to 0.77). There was also correlation between GLSR and SV (r=0.71). BLWMD was found for 17 cases (67%) at the basal and 14 cases (56%) at mid levels, and APWMD for 6 cases (22%) at the basal level.
Conclusions: In Fontan patients there is moderate correlation between strain/SR and measures of ventricular size and ejection. Annular dysfunction suggested by correlation of low basal GCS/GCSR with grade of atrioventricular valvular regurgitation, and basal BLWMD.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Redefining the “F” Word
Abstract Category: 9. Congenital Heart Disease: Adult
Presentation Number: 1270-016
- 2017 American College of Cardiology Foundation