Relation of left ventricular twist and global strain with right ventricular dysfunction in patients after operative "correction" of tetralogy of fallot

Am J Cardiol. 2010 Sep 1;106(5):723-9. doi: 10.1016/j.amjcard.2010.04.032. Epub 2010 Jul 23.


In patients with corrected tetralogy of Fallot (cToF), left ventricular (LV) dysfunction is closely related to right ventricular (RV) dysfunction, indicating adverse ventricular-ventricular interactions. However, the mechanism that links RV dysfunction to LV dysfunction remains unclear. In this prospective study, 32 patients with cToF and 19 controls were enrolled. With cardiac magnetic resonance imaging, biventricular ejection fractions were assessed. Using 2-dimensional speckle tracking, global and regional RV and LV strains and LV twist were assessed. To detect and characterize ventricular-ventricular interaction, the relation between global and regional RV mechanics and global and regional LV mechanics was assessed. Global RV strain, global LV strain, and LV twist were decreased in patients with cToF. Global RV strain correlated with global LV strain (r = 0.66, p <0.001) and LV twist (r = -0.72, p <0.001), indicating the presence of adverse ventricular-ventricular interaction. Furthermore, close relations were observed between apical RV strain and apical LV strain (r = 0.62, p <0.001) and apical LV rotation (r = -0.67, p <0.001). In conclusion, RV strain was significantly related to LV strain and LV twist in patients with cToF and controls. Furthermore, apical RV strain correlated with apical LV strain and apical LV rotation, indicating adverse apical ventricular-ventricular interactions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Cohort Studies
  • Echocardiography, Doppler, Color
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Stress, Mechanical
  • Stroke Volume
  • Tetralogy of Fallot / complications*
  • Tetralogy of Fallot / physiopathology*
  • Tetralogy of Fallot / surgery
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / epidemiology*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Right / diagnosis
  • Ventricular Dysfunction, Right / epidemiology*
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Remodeling / physiology*