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Assessment of left ventricular systolic function using tissue Doppler imaging in children after successful repair of aortic coarctation
Authors:Tomasz Florianczyk  Bozena Werner
Institution:Department of Pediatric Cardiology and General Pediatrics, The Medical University of Warsaw, Warsaw, Poland
Abstract:Aim: Assessment of left ventricular systolic function in children after the successful repair of aortic coarctation using tissue Doppler imaging (TDI). Methods: The study group consisted of 32 patients (mean age 12·0 ± 4·2 years) after the aortic coarctation repair. The TDI parameters and the conventional echocardiographic endocardial and midwall indices of the left ventricular systolic function were analysed and compared with the results obtained from 34 healthy children. Results: The systolic mitral annulus motion velocity, systolic myocardial velocity of the medial segment of the left ventricular septal wall, left ventricular strain and Strain Rate (SR) in the study group were significantly higher than in the control group, respectively: 6·92 ± 0·75 cm s?1 versus 6·45 ± 0·83 cm s?1; 5·82 ± 1·03 cm s?1 versus 5·08 ± 1·11 cm s?1; ?28·67 ± 6·04% versus ?22·53 ± 6·44% and ?3·20 ± 0·76 s?1 versus ?2·39 ± 0·49 s?1. Except midwall shortening fraction the conventional endocardial and midwall echocardiographic indices in the study group were significantly higher in comparison to the healthy controls. The left ventricular systolic meridional fibre stress and end‐systolic circumferential wall stress did not differ between the examined groups. There were no differences of the TDI or conventional parameters between hypertensive and normotensive patients. Conclusions: Left ventricular systolic performance in children after the surgical repair of aortic coarctation reveals tendency to rise in late follow‐up despite a satisfactory result after surgery. Higher systolic strain and SR in children treated due to coarctation of the aorta may suggest the increased preserved left ventricular performance despite normalization of afterload.
Keywords:coarctation of aorta  myocardial velocity  strain  strain rate  ventricular systolic function
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