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Comparison of cardiac function between single left ventricle and tricuspid atresia: assessment using echocardiography
Li-Jun Chen1, Lan-Ping Wu1, Lei-Sheng Zhao1
1Department of Pediatric Cardiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Insights
Patients with single left ventricle (SLV) and tricuspid atresia (TA) exhibit impaired cardiac function. SLV patients showed poorer outcomes than TA patients, suggesting twist may indicate left ventricular (LV) function.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Echocardiography
Background:
- Single left ventricle (SLV) and tricuspid atresia (TA) are congenital heart defects associated with impaired systolic and diastolic function.
- Comparative studies evaluating cardiac function in SLV and TA patients against healthy controls are limited.
Purpose of the Study:
- To compare cardiac function parameters in children with SLV, TA, and healthy controls.
- To investigate the correlation between echocardiographic parameters and computational fluid dynamics-derived vortex analysis.
Main Methods:
- Utilized two-dimensional echocardiography and three-dimensional speckle tracking echocardiography (3DSTE).
- Calculated vortex parameters using computational fluid dynamics.
- Compared measurements across three groups: SLV, TA, and healthy controls (15 children each).
Main Results:
- Twist demonstrated the strongest correlation with ejection fraction measured by 3DSTE.
- Cardiac function parameters including twist, torsion, and apical rotation were superior in the TA group compared to the SLV group.
- Patients with SLV exhibited more disordered blood flow patterns and less effective vortex formation than TA patients and controls.
Conclusions:
- Both SLV and TA patients present with compromised systolic and diastolic cardiac function.
- SLV patients display poorer cardiac function than TA patients, attributed to reduced compensation and disorganized blood flow.
- Twist emerges as a potentially valuable indicator of left ventricular function in these pediatric populations.
Abstract:
Patients with single left ventricle (SLV) and tricuspid atresia (TA) have impaired systolic and diastolic function. However, there are few comparative studies among patients with SLV, TA and children without heart disease. The current study includes 15 children in each group. The parameters measured by two-dimensional echocardiography, three-dimensional speckle tracking echocardiography (3DSTE), and vortexes calculated by computational fluid dynamics were compared among these three groups. Twist is best correlated with ejection fraction measured by 3DSTE. Twist, torsion, apical rotation, average radial strain, peak velocity of systolic wave in left lateral wall by tissue Doppler imaging (sL), and myocardial performance index are better in the TA group than those in the SLV group. sL by tissue Doppler imaging in the TA group are even higher than those in the Control group. In patients with SLV, blood flow spreads out in a fan-shaped manner and forms two small vortices. In the TA group, the main vortex is similar to the one in a normal LV chamber, but smaller. The vortex rings during diastolic phase are incomplete in the SLV and TA groups. In summary, patients with SLV or TA have impaired systolic and diastolic function. Patients with SLV had poorer cardiac function than those with TA due to less compensation and more disordered streamline. Twist may be good indicator for LV function.
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