Journal of the American Society of Echocardiography
Clinical InvestigationCongenital Heart DiseaseA Novel Bilayer Approach to Ventricular Septal Deformation Analysis by Speckle Tracking Imaging in Children with Right Ventricular Overload
Section snippets
Study Population
The study group comprised 22 patients with preoperative atrial septal defects (ASDs; mean age, 9.0 ± 4.2 years; range, 3.0–15.7 years) and 23 patients with surgically corrected tetralogy of Fallot (TOF; mean age, 7.2 ± 5.1 years; range, 2.5–16.2 years). We selected these two types of patients because these common and representative congenital heart diseases are both associated with right ventricular volume and/or pressure overload. Forty-four age-matched normal subjects with no
Visualization of the Septum
Standard 2D imaging data sets were obtained from all study participants. The data were of uniformly good quality and allowed subsequent offline analysis. Figures 1A and 1B show representative examples of a zoomed image of the ventricular septum. Regions of interest were positioned on the left and right sides of the septum for strain analysis (Figure 1B). Figure 1C shows a representative longitudinal strain curve. The time interval between the peak strain on the left and right sides (TLt-Rt) was
Discussion
The results of this study show that the right and left sides of the ventricular septum can be functionally differentiated. Right ventricular overload significantly influenced myocardial deformation of both sides of the septum in terms of magnitude and the timing of strain. Quantitation of right ventricular function is an important prognostic factor, especially in patients with congenital heart disease.1 Some investigators have proposed that the ventricular septum has an essential impact on
Conclusions
Differences in deformation between the two sides of the ventricular septum can be observed using speckle-tracking imaging. To evaluate strain on each side is useful to determine right ventricular performance. Further studies are needed to determine if septal bilayer form and multidirectional myocardial function could serve as important guidelines for assessing right ventricular function.
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