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SHR Neuro Cancer Cardio Lipid Metab Microb

Cantinotti, M; Marchese, P; Scalese, M; Medino, P; Jani, V; Franchi, E; Vitali, P; Santoro, G; Viacava, C; Assanta, N; Kutty, S; Koestenberger, M; Giordano, R.
Left Ventricular Systolic Impairment after Pediatric Cardiac Surgery Assessed by STE Analysis.
Healthcare (Basel). 2021; 9(10): Doi: 10.3390/healthcare9101338 [OPEN ACCESS]
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Co-authors Med Uni Graz

Koestenberger Martin

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Abstract:

BACKGROUND: Speckle-tracking echocardiography (STE) has gained increasing value in the evaluation of congenital heart diseases (CHD); however, its use in pediatric cardiac surgery is limited. AIM: To evaluate left ventricular (LV) systolic impairment after biventricular pediatric cardiac surgery by STE strain (ε) analysis. METHODS: We prospectively enrolled 117 children undergoing cardiac surgery for CHD. Echocardiography was performed at four different times: pre-operatively, 12-36 h (Time 1), 3-5 days (Time 2), and 6-8 days (Time 3). Images were obtained in the 4-2-and 3 apical chamber's views to derive LV global and regional (basal/mid/apical) ε values. RESULTS: At different postoperative times, we performed 320 examinations in 117 children (mean age: 2.4 ± 3.9, range: 0-16 years); 117 age-matched healthy children served as controls. All global, basal, and mid LVε values decreased after surgery; the lowest values being at Time 1 (p < 0.0001), which increased thereafter. At discharge, all global, basal, and mid LVε values remained lower than in pre-operative and healthy children (p < 0.05). Instead, apical segments (lowest at baseline) increased after surgery (p < 0.0001) but remained lower compared to controls. LV ejection fraction (LVEF) decreased at Time 1 (p = 0.0004) but promptly recovered to Time 2 and normalized at Time 3. CONCLUSIONS: STE ε analysis revealed a significant LV systolic impairment after surgery with amelioration thereafter but incomplete normalization at discharge. Base-apex differences emerged with apical segments that, contrary to all the other regions, showed relative hypercontractility after surgery. The slower recovery of LVε values compared to LVEF suggests that STE ε analysis may be more accurate for the follow-up of mild LV post-surgical impairment.

Find related publications in this database (Keywords)

echocardiography

congenital heart disease

cardiac surgery

speckle tracking echocardiography

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