Quantitative echocardiographic measures in the assessment of single ventricle function post-Fontan: Incorporation into routine clinical practice.
Echocardiography
; 34(1): 108-115, 2017 Jan.
Article
in En
| MEDLINE
| ID: mdl-27862239
ABSTRACT
BACKGROUND:
Quantitative echocardiographic measurements of single ventricular (SV) function have not been incorporated into routine clinical practice.METHODS:
A clinical protocol, which included quantitative measurements of SV deformation (global circumferential and longitudinal strain and strain rate), standard deviation of time to peak systolic strain, myocardial performance index (MPI), dP/dT from an atrioventricular valve regurgitant jet, and superior mesenteric artery resistance index, was instituted for all patients with a history of Fontan procedure undergoing echocardiography. All measures were performed real time during clinically indicated studies and were included in clinical reports.RESULTS:
A total of 100 consecutive patients (mean age = 11.95±6.8 years, range 17 months-31.3 years) completed the protocol between September 1, 2014 to April 29, 2015. Deformation measures were completed in 100% of the studies, MPI in 93%, dP/dT in 55%, and superior mesenteric artery Doppler in 82%. The studies were reviewed to assess for efficiency in completing the protocol. The average time for image acquisition was 27.4±8.8 (range 10-62 minutes). The average time to perform deformation measures was 10.8±5.5 minutes (range 5-35 minutes) and time from beginning of imaging to report completion was 53.4±13.7 minutes (range 27-107 minutes). There was excellent inter-observer reliability when deformation indices were blindly repeated. Patients with a single left ventricle had significantly higher circumferential strain and strain rate, longitudinal strain and strain rate, and dP/dT compared to a single right ventricle. There were no differences in quantitative indices of ventricular function between patients <10 vs. >10 years post-Fontan.CONCLUSION:
Advanced quantitative assessment of SV function post-Fontan can be consistently and efficiently performed real time during clinically indicated echocardiograms with excellent reliability.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Echocardiography, Doppler
/
Ventricular Function, Right
/
Fontan Procedure
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Heart Defects, Congenital
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Heart Ventricles
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Myocardial Contraction
Type of study:
Diagnostic_studies
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Guideline
Limits:
Adolescent
/
Adult
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Language:
En
Journal:
Echocardiography
Journal subject:
CARDIOLOGIA
/
DIAGNOSTICO POR IMAGEM
Year:
2017
Type:
Article
Affiliation country:
United States