Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Year : 2021  |  Volume : 31  |  Issue : 3  |  Page : 144-150

Comparison of myocardial deformation by speckle-tracking echocardiography and cardiac magnetic resonance in patients with fontan circulation: Diagnostic algorithm

1 Department of Pediatric Cardiology, La Paz University Hospital, Madrid, Spain
2 Department of Radiology, La Paz University Hospital, Madrid, Spain
3 Department of Statistics, La Paz University Hospital, Madrid, Spain
4 Department of Cardiovascular Surgery, La Paz University Hospital, Madrid, Spain

Correspondence Address:
Elena Sanz Pascual
Department of Pediatric Cardiology, La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcecho.jcecho_126_20

Rights and Permissions

Background: While the short- and median-term survival has improved considerably in patients with Fontan circulation, cardiac function and exercise capacity are still reduced and may deteriorate over time. Cardiac magnetic resonance (CMR) is the gold standard for the assessment of ventricular volume and function. Speckle-tracking echocardiography (STE) is a myocardial deformation technique to assess ventricular function, with promising results. The aim of our study is to validate STE and conventional echocardiography parameters and to compare them with CMR. Furthermore, we aimed to design a diagnostic algorithm applying some parameters in series for early detection of myocardial dysfunction. Materials and Methods: We performed a cross-sectional single-center study in 64 patients with Fontan circulation. Longitudinal and circumferential strain, strain rates, and conventional echocardiographic measurements were registered. Ventricular volumes and ejection fraction (EF) were obtained by CMR. Results: Seven patients presented ventricular dysfunction (EF <45% by CMR), without showing a significant correlation between STE parameters or conventional measures by echocardiography and CMR. After the application of the diagnostic algorithm with the optimal cutoff points (global longitudinal strain – 24.5%, global circumferential strain – 20%, and annular plane systolic excursion – 16.5 mm), we got a sensitivity rate and a negative predictive value of 100%. In 19 patients (40.1%), the absence of ventricular dysfunction was demonstrated without no false-negative cases. Conclusions: STE should be considered a complementary diagnostic tool in Fontan patients. These suggested parameters applied in series are a useful tool for identifying early ventricular dysfunction and for diagnostic tests improvement with a fewer CMRs in the follow-up of these patients.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded65    
    Comments [Add]    

Recommend this journal