Mối quan hệ giữa rối loạn chức năng tâm trương thất phải và thất trái được đánh giá bằng siêu âm tim theo dõi điểm chùm 2 chiều ở người lớn đã được sửa chữa tứ chứng Fallot

Springer Science and Business Media LLC - Tập 37 - Trang 569-576 - 2020
Makoto Miyake1,2,3, Rie Abe4, Hayato Matsutani4, Jiro Sakamoto1, Hirokazu Kondo1, Atsushi Iwakura5, Hiraku Doi2, Toshihiro Tamura1
1Department of Cardiology, Tenri Hospital, Tenri, Japan
2Congenital Heart Disease Center, Tenri Hospital, Tenri, Japan
3Department of Cardiology, Congenital Heart Disease Center, Tenri Hospital, Tenri, Japan
4Department of Clinical Laboratory, Tenri Hospital, Tenri, Japan
5Department of Cardiovascular Surgery, Tenri Hospital, Tenri, Japan

Tóm tắt

Nhiều nghiên cứu đã báo cáo mối tương quan giữa rối loạn chức năng tâm thu thất phải (RV) và thất trái (LV) ở người trưởng thành mắc bệnh tứ chứng Fallot (TOF) đã được sửa chữa. Tuy nhiên, dữ liệu về mối liên hệ giữa rối loạn chức năng tâm trương của RV và LV được đánh giá bằng siêu âm tim theo dõi điểm chùm 2 chiều còn thiếu. Chúng tôi đã nghiên cứu 69 người lớn mắc TOF đã được sửa chữa (độ tuổi trung bình 34 tuổi, 61% là nam) và đã được theo dõi định kỳ và thường xuyên thực hiện siêu âm tim. Ngoài siêu âm tim thông thường, chúng tôi còn đánh giá độ biến đổi toàn cầu theo chiều dọc (GLS) và tỷ lệ biến đổi tâm trương sớm (SRe) của cả hai thất bằng siêu âm tim theo dõi điểm chùm 2 chiều. Kết quả được so sánh với 30 đối chứng cùng độ tuổi và giới tính. GLS của RV và LV giảm ở bệnh nhân TOF so với nhóm đối chứng (− 18,4 ± 3,3% so với −23,5 ± 4,2%, p < 0,001 và − 16,0 ± 3,8% so với −20,0 ± 3,0%, p < 0,001, tương ứng). SRe của RV và LV cũng giảm ở bệnh nhân TOF so với nhóm đối chứng (1,22 ± 0,34 giây− 1 so với 1,47 ± 0,41 giây− 1, p = 0,003 và 1,29 ± 0,42 giây− 1 so với 1,63 ± 0,42 giây− 1, p < 0,001, tương ứng). Một mối tương quan giữa SRe của RV và LV được tìm thấy ở bệnh nhân TOF (r = 0,43, p < 0,001) cũng như giữa GLS của RV và LV (r = 0,45, p < 0,001). Siêu âm tim theo dõi điểm chùm 2 chiều cho thấy rối loạn chức năng tâm trương RV và LV tiềm ẩn ở người lớn mắc TOF đã được sửa chữa. Một mối tương quan được quan sát giữa rối loạn chức năng tâm trương RV và LV cũng như giữa rối loạn chức năng tâm thu RV và LV.

Từ khóa

#Rối loạn chức năng tâm trương #tứ chứng Fallot #siêu âm tim theo dõi điểm chùm 2 chiều #thất phải #thất trái

Tài liệu tham khảo

Apitz C, Webb GD, Redington AN (2009) Tetralogy of Fallot. Lancet 374:1462–1471 Murphy JG, Gersh BJ, Mair DD, Fuster V, McGoon MD, Ilstrup DM et al (1993) Long-term outcome in patients undergoing surgical repair of tetralogy of Fallot. N Engl J Med 329:593–599 Nollert G, Fischlein T, Bouterwek S, Böhmer C, Klinner W, Reichart B (1997) Long-term survival in patients with repair of tetralogy of Fallot: 36-year follow-up of 490 survivors of the first year after surgical repair. J Am Coll Cardiol 30:1374–1383 Frigiola A, Redington AN, Cullen S, Vogel M (2004) Pulmonary regurgitation is an important determinant of right ventricular contractile dysfunction in patients with surgically repaired tetralogy of Fallot. Circulation 110:II153–I157 Marie PY, Marçon F, Brunotte F, Briançon S, Danchin N, Worms AM et al (1992) Right ventricular overload and induced sustained ventricular tachycardia in operatively “repaired” tetralogy of Fallot. Am J Cardiol 69:785–789 Gatzoulis MA (2000) Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot: a multicentre study. Lancet 356:975–981 Geva T, Sandweiss BM, Gauvreau K, Lock JE, Powell AJ (2004) Factors associated with impaired clinical status in long-term survivors of tetralogy of Fallot repair evaluated by magnetic resonance imaging. J Am Coll Cardiol 43:1068–1074 Ghai A, Silversides C, Harris L, Webb GD, Siu SC, Therrien J (2002) Left ventricular dysfunction is a risk factor for sudden cardiac death in adults late after repair of tetralogy of Fallot. J Am Coll Cardiol 40:1675–1680 Knauth AL, Gauvreau K, Powell AJ, Landzberg MJ, Walsh EP, Lock JE et al (2008) Ventricular size and function assessed by cardiac MRI predict major adverse clinical outcomes late after tetralogy of Fallot repair. Heart 94:211–216 Diller GP, Kempny A, Liodakis E, Alonso-Gonzalez R, Inuzuka R, Uebing A et al (2012) Left ventricular longitudinal function predicts life-threatening ventricular arrhythmia and death in adults with repaired tetralogy of Fallot. Circulation 125:2440–2446 Broberg CS, Aboulhosn J, Mongeon FP, Kay J, Valente AM, Khairy P et al (2011) Prevalence of left ventricular systolic dysfunction in adults with repaired tetralogy of Fallot. Am J Cardiol 107:1215–1220 Kempny A, Diller GP, Orwat S, Kaleschke G, Kerckhoff G, Bunck, ACh et al (2012) Right ventricular-left ventricular interaction in adults with Tetralogy of Fallot: a combined cardiac magnetic resonance and echocardiographic speckle tracking study. Int J Cardiol 154:259–264 Davlouros PA, Kilner PJ, Hornung TS, Li W, Francis JM, Moon JC et al (2002) Right ventricular function in adults with repaired tetralogy of Fallot assessed with cardiovascular magnetic resonance imaging: detrimental role of right ventricular outflow aneurysms or akinesia and adverse right-to-left ventricular interaction. J Am Coll Cardiol 40:2044–2052 Menting ME, van den Bosch AE, McGhie JS, Eindhoven JA, Cuypers JA, Witsenburg M et al (2015) Assessment of ventricular function in adults with repaired Tetralogy of Fallot using myocardial deformation imaging. Eur Heart J Cardiovasc Imaging 16:1347–1357 Schwartz MC, Rome JJ, Gillespie MJ, Whitehead K, Harris MA, Fogel MA et al (2012) Relation of left ventricular end diastolic pressure to right ventricular end diastolic volume after operative treatment of tetralogy of Fallot. Am J Cardiol 109:417–422 Ahmad N, Kantor PF, Grosse-Wortmann L, Seller N, Jaeggi ET, Friedberg MK et al (2012) Influence of RV restrictive physiology on LV diastolic function in children after tetralogy of Fallot repair. J Am Soc Echocardiogr 25:866–873 Friedberg MK, Fernandes FP, Roche SL, Grosse-Wortmann L, Manlhiot C, Fackoury C et al (2012) Impaired right and left ventricular diastolic myocardial mechanics and filling in asymptomatic children and adolescents after repair of tetralogy of Fallot. Eur Heart J Cardiovasc Imaging 13:905–913 Aboulhosn JA, Lluri G, Gurvitz MZ, Khairy P, Mongeon FP, Kay J et al (2013) Left and right ventricular diastolic function in adults with surgically repaired tetralogy of Fallot: a multi-institutional study. Can J Cardiol 29:866–872 Lubert AM, Cotts TB, Zampi JD, Yu S, Norris MD (2019) Echocardiographic predictors of elevated left ventricular end diastolic pressure in adolescent and adult patients with repaired tetralogy of Fallot. Cardiol Young 29:1020–1024 Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28:1–39 Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM et al (2019) 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 139:e698–e800 Morris DA, Krisper M, Nakatani S, Köhncke C, Otsuji Y, Belyavskiy E et al (2017) Normal range and usefulness of right ventricular systolic strain to detect subtle right ventricular systolic abnormalities in patients with heart failure: a multicentre study. Eur Heart J Cardiovasc Imaging 18:212–223 Wang J, Khoury DS, Thohan V, Torre-Amione G, Nagueh SF (2007) Global diastolic strain rate for the assessment of left ventricular relaxation and filling pressures. Circulation 115:1376–1383 Dokainish H, Sengupta R, Pillai M, Bobek J, Lakkis N (2008) Usefulness of new diastolic strain and strain rate indexes for the estimation of left ventricular filling pressure. Am J Cardiol 101:1504–1509 Lassen MCH, Biering-Sørensen SR, Olsen FJ, Skaarup KG, Tolstrup K, Qasim AN et al (2019) Ratio of transmitral early filling velocity to early diastolic strain rate predicts long-term risk of cardiovascular morbidity and mortality in the general population. Eur Heart J 40:518–525 Dahl JS, Barros-Gomes S, Videbæk L, Poulsen MK, Issa IF, Carter-Storch R et al (2016) Early Diastolic Strain Rate in Relation to Systolic and Diastolic Function and Prognosis in Aortic Stenosis. JACC Cardiovasc Imaging 9:519–528 Ersbøll M, Andersen MJ, Valeur N, Mogensen UM, Fakhri Y, Thune JJ et al (2014) Early diastolic strain rate in relation to systolic and diastolic function and prognosis in acute myocardial infarction: a two-dimensional speckle-tracking study. Eur Heart J 35:648–656 Hayabuchi Y, Sakata M, Ohnishi T, Inoue M, Kagami S (2013) Ratio of early diastolic tricuspid inflow to tricuspid lateral annulus velocity reflects pulmonary regurgitation severity but not right ventricular diastolic function in children with repaired Tetralogy of Fallot. Pediatr Cardiol 34:1112–1117 DiLorenzo M, Hwang WT, Goldmuntz E, Ky B, Mercer-Rosa L (2018) Diastolic dysfunction in tetralogy of Fallot: Comparison of echocardiography with catheterization. Echocardiography 35:1641–1648 Valente AM, Cook S, Festa P, Ko HH, Krishnamurthy R, Taylor AM et al (2014) Multimodality imaging guidelines for patients with repaired tetralogy of Fallot: a report from the American Society of Echocardiography: developed in collaboration with the Society for Cardiovascular Magnetic Resonance and the Society for Pediatric Radiology. J Am Soc Echocardiogr 27:111–141 Chen CA, Dusenbery SM, Valente AM, Powell AJ, Geva T (2016) Myocardial ECV Fraction Assessed by CMR Is Associated With Type of Hemodynamic Load and Arrhythmia in Repaired Tetralogy of Fallot. JACC Cardiovasc Imaging 9:1–10 Cochet H, Iriart X, Allain-Nicolaï A, Camaioni C, Sridi S, Nivet H et al (2019) Focal scar and diffuse myocardial fibrosis are independent imaging markers in repaired tetralogy of Fallot. Eur Heart J Cardiovasc Imaging 20:990–1003 Torrent-Guasp F, Ballester M, Buckberg GD, Carreras F, Flotats A, Carrió I et al (2001) Spatial orientation of the ventricular muscle band: physiologic contribution and surgical implications. J Thorac Cardiovasc Surg 122:389–392 Zile MR, Brutsaert DL (2002) New concepts in diastolic dysfunction and diastolic heart failure: Part II: causal mechanisms and treatment. Circulation 105:1503–1508 Bolger AP, Sharma R, Li W, Leenarts M, Kalra PR, Kemp M (2002) Neurohormonal activation and the chronic heart failure syndrome in adults with congenital heart disease. Circulation 106:92–99 Jeewa A, Manickaraj AK, Mertens L, Manlhiot C, Kinnear C, Mondal T et al (2012) Genetic determinants of right-ventricular remodeling after tetralogy of Fallot repair. Pediatr Res 72:407–413 Uebing A, Gibson DG, Babu-Narayan SV, Diller GP, Dimopoulos K, Goktekin O et al (2007) Right ventricular mechanics and QRS duration in patients with repaired tetralogy of Fallot: implications of infundibular disease. Circulation 116:1532–1539 van der Hulst AE, Roest AA, Delgado V, Holman ER, de Roos A, Blom NA et al (2011) Relationship between temporal sequence of right ventricular deformation and right ventricular performance in patients with corrected tetralogy of Fallot. Heart 97:231–236