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Quantitative analysis of right atrial performance after surgical repair of tetralogy of Fallot

Published online by Cambridge University Press:  21 January 2005

Wei Hui ,
Mohamed Y. Abd El Rahman ,
Fatima Dsebissowa ,
Axel Rentzsch ,
Matthias Gutberlet ,
Vladimir Alexi-Meskishvili ,
Roland Hetzer ,
Peter E. Lange  and
Hashim Abdul-Khaliq
Wei Hui
Affiliation:
Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University, Berlin, Germany
Mohamed Y. Abd El Rahman
Affiliation:
Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University, Berlin, Germany
Fatima Dsebissowa
Affiliation:
Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University, Berlin, Germany
Axel Rentzsch
Affiliation:
Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University, Berlin, Germany
Matthias Gutberlet
Affiliation:
Department of Radiology and Nuclear Medicine, University Hospital Charité, Humboldt University, Berlin, Germany
Vladimir Alexi-Meskishvili
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany
Roland Hetzer
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany
Peter E. Lange
Affiliation:
Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University, Berlin, Germany
Hashim Abdul-Khaliq
Affiliation:
Department of Congenital Heart Defects/Paediatric Cardiology, University Hospital Charité, Humboldt University, Berlin, Germany
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Abstract

We aimed to assess the right atrial performance in patients after surgical correction of tetralogy of Fallot, and to clarify the relationship between the pump function of the right atrium and right ventricular systolic function.

We included in the study 50 asymptomatic patients following corrective surgery of tetralogy of Fallot, comparing them to 30 normal subjects. Right atrial areas were measured by echocardiography, and the active fractional area of emptying was expressed, in percentages, as the area measured at the onset of atrial contraction, minus the minimal area, divided by the area at the onset of atrial contraction. We used this value to assess the atrial pump function. Right atrial peak strain rates were measured by tissue Doppler imaging. Compared to controls, patients with tetralogy of Fallot had a significantly reduced right atrial active fractional area of emptying (p = 0.005), along with a reduced peak late diastolic strain rate (p = 0.002). Among 20 patients who underwent magnetic resonance tomographic examination, a relatively higher right atrial peak late diastolic strain rate was shown in patients with a right ventricular ejection fraction of less than 50% (p = 0.021).

Right atrial performance is reduced in patients after surgical correction of tetralogy of Fallot. When facing right ventricular systolic dysfunction, nonetheless, the right atrial pump function may be relatively enhanced. Tissue Doppler derived strain rate can provide quantitative analysis of regional right atrial performance.

Keywords

Tissue Doppler imagingatrial pump functioncongenital cardiac disease
Type
Original Article
Information
Cardiology in the Young , Volume 14 , Issue 5 , October 2004 , pp. 520 - 526
Copyright
© 2004 Cambridge University Press

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