Quantitative echocardiographic measures in the assessment of single ventricle function post-Fontan: Incorporation into routine clinical practice. Echocardiography 2017 Jan;34(1):108-115
Date
11/20/2016Pubmed ID
27862239DOI
10.1111/echo.13408Scopus ID
2-s2.0-85006061953 (requires institutional sign-in at Scopus site) 16 CitationsAbstract
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.
Author List
Rios R, Ginde S, Saudek D, Loomba RS, Stelter J, Frommelt PAuthors
Peter C. Frommelt MD Adjunct Professor in the Pediatrics department at Medical College of WisconsinSalil Ginde MD, MPH Associate Professor in the Pediatrics department at Medical College of Wisconsin
David Saudek MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Child
Child, Preschool
Echocardiography, Doppler
Female
Fontan Procedure
Heart Defects, Congenital
Heart Ventricles
Humans
Infant
Male
Myocardial Contraction
Reproducibility of Results
Stroke Volume
Systole
Ventricular Function, Right
Young Adult
