Impaired Single Right Ventricular Function Compared to Single Left Ventricles during the Early Stages of Palliation: A Longitudinal Study

Somjate Suntratonpipat, Nee S. Khoo, Timothy Colen, Mohammed Alhabdan, Dongngan Troung, Norazah Zahari, Shelby Kutty, Jeffrey F. Smallhorn, Edythe B. Tham

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background Single right ventricles (SRV) are postulated to be disadvantaged compared with single left ventricles (SLV). We compared the evolution of SRV versus SLV function during infancy using conventional measures and speckle-tracking echocardiography (STE). We hypothesized that the SRV is mechanically disadvantaged during early infancy. Methods SRVs (n = 32) were compared with SLVs (n = 16) at the neonatal (presurgery) and pre-bidirectional cavopulmonary anastomosis (pre-BCPA) stages. Functional measures (fractional area change, indexed ventricular annular plane systolic excursion [iVAPSE], isovolumic acceleration [IVA], myocardial performance index, E and A velocities, tissue Doppler imaging annular velocities and STE-measured global longitudinal and circumferential strain, strain rate [SR], and early diastolic SR [EDSR]) were compared between SRV and SLV at each stage and between presurgery and pre-BCPA. Results Compared with SLV, presurgery SRV had lower circumferential strain (−10.6% vs −16.5%; P = .0002) and EDSR (1.41%/sec vs 2.13%/sec; P = .001). Pre-BCPA SRV had decreased IVA (1.2 vs 2.1 m/sec2; P = .006): longitudinal strain (−15.3% vs −19.1%; P = .001), SR (−0.97%/sec vs −1.53%/sec; P = .0001), EDSR (1.5%/sec vs 2.1%/sec; P = .001); circumferential strain (−10.6% vs −14.9%; P = .002), SR (−0.8%/sec vs −1.21%/sec; P = .0001), and EDSR (1.3%/sec vs 1.8%/sec; P = .009). SRV showed reduction of iVAPSE, IVA, s′, e′, a′ velocities, longitudinal strain, SR, EDSR, and circumferential SR (P < .05) from presurgery to pre-BCPA, while circumferential strain was unchanged. SLV showed no significant change in these parameters during this interval. Conclusions The progressive reduction in SRV longitudinal and circumferential function suggests that SRV may have a mechanical disadvantage from birth and progressive impairment with age.

Original languageEnglish (US)
Pages (from-to)468-477
Number of pages10
JournalJournal of the American Society of Echocardiography
Volume30
Issue number5
DOIs
StatePublished - May 2017

Keywords

  • Echocardiography
  • Single ventricle
  • Speckle-tracking imaging
  • Strain
  • Ventricular function

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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