Journal of Cardiovascular Echography

ORIGINAL ARTICLE
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


Elena Sanz Pascual1, Montserrat Bret Zurita2, Jesus Diez Sebastián3, Luis García-Guereta Silva1, Angel Aroca Peinado4, Federico Gutiérrez-Larraya Aguado1 
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
Spain

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.


How to cite this article:
Pascual ES, Zurita MB, Sebastián JD, Silva LG, Peinado AA, Aguado FG. Comparison of myocardial deformation by speckle-tracking echocardiography and cardiac magnetic resonance in patients with fontan circulation: Diagnostic algorithm.J Cardiovasc Echography 2021;31:144-150


How to cite this URL:
Pascual ES, Zurita MB, Sebastián JD, Silva LG, Peinado AA, Aguado FG. Comparison of myocardial deformation by speckle-tracking echocardiography and cardiac magnetic resonance in patients with fontan circulation: Diagnostic algorithm. J Cardiovasc Echography [serial online] 2021 [cited 2021 Nov 29 ];31:144-150
Available from: https://www.jcecho.org/article.asp?issn=2211-4122;year=2021;volume=31;issue=3;spage=144;epage=150;aulast=Pascual;type=0