Longitudinal Myocardial Deformation Does Not Predict Single Ventricle Ejection Fraction Assessed by Cardiac Magnetic...

Area of Science:

• Pediatric Cardiology
• Cardiac Imaging
• Echocardiography

Background:

• Survival rates for children with single ventricle heart defects post-total cavopulmonary connection (TCPC) have improved.
• Impaired cardiac function remains a significant cause of morbidity and mortality in these patients.
• Cardiac magnetic resonance imaging (cMRI) is the gold standard for assessing single ventricle function but is costly and less accessible.

Purpose of the Study:

• To investigate the association between myocardial deformation measured by speckle tracking echocardiography (STE) and single ventricle (SV) function assessed by cMRI.
• To compare myocardial deformation in children with single left versus single right ventricular morphology after TCPC.

Main Methods:

• A cross-sectional, multicenter study involving 77 children post-TCPC.
• Measurement of STE segmental and global longitudinal peak strain and systolic strain rate (SR) in the dominant ventricle.
• Definition of impaired SV function by cMRI as ejection fraction (EF) < 45%.

Main Results:

• No significant correlation was found between cMRI ejection fraction and STE global longitudinal strain (Pearson R = -0.25, p = 0.06) or strain rate (Pearson R = -0.03, p = 0.82).
• Global single ventricle longitudinal strain and SR were similar in patients with single left and single right ventricular morphology.
• STE-derived myocardial deformation parameters did not correlate with SV ejection fraction assessed by cMRI.

Conclusions:

• Speckle tracking echocardiography myocardial deformation parameters do not correlate with single ventricle ejection fraction assessed by cMRI in children after TCPC.
• STE may not be a reliable non-invasive tool for assessing single ventricle function in this population.
• Further research is needed to explore alternative echocardiographic methods for evaluating cardiac function post-TCPC.