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Nemes A. Myocardial, Valvular and Vascular Abnormalities in Repaired Tetralogy of Fallot. Life (Basel) 2024; 14:843. [PMID: 39063597 PMCID: PMC11277634 DOI: 10.3390/life14070843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/07/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
Tetralogy of Fallot is the most common heart defect associated with cyanosis characterized by the co-occurrence of pulmonary stenosis, right ventricular hypertrophy, and ventricular septal defect with over-riding of the aorta. The present review purposed to summarize myocardial, valvular and vascular abnormalities, which were described in a series of patients following repair of tetralogy of Fallot. It was also aimed to describe potential differences in these parameter using different surgical strategies.
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Affiliation(s)
- Attila Nemes
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis Street 8, P.O. Box 427, H-6725 Szeged, Hungary
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Nemes A, Kormányos Á, Ruzsa Z, Achim A, Ambrus N, Lengyel C. Complexity of left ventricular strains in response to elevated volumes in healthy adults - Detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study. IJC HEART & VASCULATURE 2023; 47:101236. [PMID: 37484064 PMCID: PMC10359859 DOI: 10.1016/j.ijcha.2023.101236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/14/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023]
Abstract
Introduction Cardiac haemodynamics is described by the Frank-Starling law, which states that the strength of the left ventricular (LV) systolic contraction is related to the LV diastolic filling, with other words LV stroke volume increases as LV volume increases due to the stretching of the myocyte. The purpose of the present study was to examine how the increasing LV volumes affect LV contractility represented by three-dimensional (3D) speckle-tracking echocardiography (3DSTE) -derived LV strains in healthy adults. Methods This is post-hoc analysis of the MAGYAR-Healthy Study employing a novel method for technical analysis of echocardiographic datasets. The present study consisted of 301 healthy adults. Due to inferior image quality, 127 subjects have been excluded, therefore the remaining population included 174 subjects (mean age: 32.9 ± 12.1 years, 80 males). All cases have undergone complete two-dimensional Doppler echocardiography extended with 3DSTE. Results LV global longitudinal (gLS) and area (gAS) strains were lowest in case of the highest LV end-diastolic volume (EDV). LV global radial (gRS) and 3D (g3DS) strains tendentiously increased with increasing LV-EDV. When segmental analysis was performed, increased LV-EDV was associated with increase of basal LV-RS and LV-3DS. Increased LV strains were associated with increased LV ejection fraction (EF) due to higher LV-EDV for LV-gRS (and LV-g3DS), lower LV-ESV for LV-gCS and lower LV-EDV and LV-ESV for LV-gLS (and LV-gAS). With increasing LV-gRS, LV-gCS and LV-g3DS, all LV strains increased except LV-gLS. With increasing LV-gLS, LV-gRS did not show any increase, LV-gCS and LV-g3DS were the highest when LV-gLS was the highest, while LV-gAS increased simultaneously. With increasing LV-gAS, all LV strains increased. Conclusions There is a complex contractility pattern of LV segments/regions in response to elevated LV volumes in healthy circumstances.
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Affiliation(s)
- Attila Nemes
- Corresponding author at: Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Semmelweis street 8, P.O. Box 427, Hungary.
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Sun ZY, Li Q, Li J, Zhang MW, Zhu L, Geng J. Echocardiographic evaluation of the right atrial size and function: Relevance for clinical practice. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2023; 27:100274. [PMID: 38511096 PMCID: PMC10945901 DOI: 10.1016/j.ahjo.2023.100274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/12/2023] [Accepted: 02/13/2023] [Indexed: 03/22/2024]
Abstract
Right atrial (RA) structural and functional evaluations have recently emerged as powerful biomarkers for adverse events in various cardiovascular conditions. Quantitative analysis of the right atrium, usually performed with volume changes or speckle-tracking echocardiography (STE), has markedly changed our understanding of RA function and remodeling. Knowledge of reference echocardiographic values and measurement methods of RA volumes and myocardial function is a prerequisite to introduce RA quantitation in the clinical routine. This review describes the methodology, benefits and pitfalls of measuring RA size and function by echocardiography based on the current understanding of right atrial anatomy and physiological function and provides the current knowledge of right atrial function in related cardiac diseases.
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Affiliation(s)
- Zhen-Yun Sun
- Department of Diagnostic Ultrasound, Shandong First Medical University & Shandong Academy of Medical Sciences, China
| | - Qiao Li
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Jun Li
- Department of Diagnostic Ultrasound, Shandong First Medical University & Shandong Academy of Medical Sciences, China
| | - Ming-Wei Zhang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Ling Zhu
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Jing Geng
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
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Nemes A, Rácz G, Kormányos Á, Ambrus N, Havasi K. Tricuspid annular abnormalities following different surgical strategies in adults with corrected tetralogy of Fallot (Results from the CSONGRAD Registry and MAGYAR-Path Study). Cardiovasc Diagn Ther 2021; 11:1276-1283. [PMID: 35070797 PMCID: PMC8748490 DOI: 10.21037/cdt-21-256] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2023]
Abstract
BACKGROUND Although there is an increasing number of patients with corrected tetralogy of Fallot (cTOF), who reach adulthood due to recent successful surgical procedures, some of them suffers from late complications, including functional tricuspid regurgitation (FTR). The purpose of the present study was to examine tricuspid annular (TA) abnormalities in adult cTOF patients and their relationship right atrial (RA) volumes respecting the cardiac cycle assessed by three-dimensional speckle-tracking echocardiography (3DSTE). Moreover, the effect of different surgical procedures on TA morphologic and functional parameters was examined as well. METHODS The study comprised 24 cTOF patients (32.8±13.5 years, 9 males) in which early palliative surgery and late total correction were performed in 12 cases (pcTOF), while early total reconstruction was performed in 12 subjects (etrTOF). Their results were compared to those of 33 matched healthy adults (36.7±7.2 years, 15 males). RESULTS Dilated end-systolic and end-diastolic TA morphologic parameters and their body surface area-indexed counterpart could be detected in cTOF patients as compared to that of controls. TA fractional area change and TA fractional shortening proved to be reduced in cTOF patients as well as in etrTOF and pcTOF patients compared to controls. None of the TA morphologic and functional parameters showed any differences between etrTOF and pcTOF patients. Increased maximum, preatrial contraction and minimum RA volumes could be detected in cTOF patients compared to controls, which correlated with TA dimensions. CONCLUSIONS TA is dilated with reduced function in adult patients with cTOF. TA dilation is related to RA volumes. etrTOF and pcTOF patients have similar TA dimensions and TA functional properties. KEYWORDS Fallot; tricuspid annulus; three-dimensional (3D); speckle-tracking; echocardiography.
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Affiliation(s)
- Attila Nemes
- Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Gergely Rácz
- Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Árpád Kormányos
- Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nóra Ambrus
- Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Kálmán Havasi
- Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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Kormányos Á, Kalapos A, Domsik P, Gyenes N, Ambrus N, Valkusz Z, Lengyel C, Nemes A. The right atrium in acromegaly-a three-dimensional speckle-tracking echocardiographic analysis from the MAGYAR-Path Study. Quant Imaging Med Surg 2020; 10:646-656. [PMID: 32269925 PMCID: PMC7136732 DOI: 10.21037/qims.2020.02.05] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 01/23/2020] [Indexed: 08/06/2023]
Abstract
BACKGROUND Acromegaly is a chronic, rare hormonal disease associated with major cardiovascular co-morbidities. The disease, in the majority of the cases, is caused by a benign human growth hormone (hGH) secreting adenoma. Cardiovascular involvement is especially common in acromegalic patients from the most common hypertension to cardiomyopathy. Left ventricular hypertrophy and myocardial fibrosis are considered common findings in acromegalic cardiomyopathy, which might result in severe heart failure at end-stages. It was set out to quantify right atrial (RA) morphology and function in a group of acromegalic patients using three-dimensional (3D) speckle-tracking echocardiography (3DSTE). METHODS The study comprised 30 patients from which 8 patients were excluded due to inadequate image quality. Mean age of the remaining acromegaly patients were 53.7±14.5 years (7 males). In the control group 44 healthy adults were enrolled (mean age: 50.7±12.6 years, 15 males). In each case, complete two-dimensional Doppler echocardiography was performed followed by 3DSTE. RESULTS All three RA volumetric parameters (Vmax, Vmin, VpreA) were significantly higher in case of acromegaly compared to the healthy controls. Strain analysis revealed that RA function may be enhanced in acromegalic patients, which is more notable in case of active acromegaly. Numerous independent strain parameters had significant correlations with different hormonal variables in the active acromegaly group. These correlations were not present in the inactive acromegaly subgroup. CONCLUSIONS Acromegaly has a profound effect on RA function and with proper treatment these changes partly seem to be reversible.
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Affiliation(s)
- Árpád Kormányos
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Péter Domsik
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nándor Gyenes
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nóra Ambrus
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Zsuzsanna Valkusz
- 1st Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Csaba Lengyel
- 1st Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Attila Nemes
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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Nemes A, Kormányos Á, Havasi K, Kovács Z, Domsik P, Kalapos A, Hartyánszky I, Ambrus N, Forster T. Mitral annulus is enlarged and functionally impaired in adult patients with repaired tetralogy of Fallot as assessed by three-dimensional speckle-tracking echocardiography-results from the CSONGRAD Registry and MAGYAR-Path Study. Cardiovasc Diagn Ther 2019; 9:S221-S227. [PMID: 31737530 DOI: 10.21037/cdt.2019.06.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Fibrous mitral annulus (MA) is an important part of the mitral valve having a role in forwarding blood from the left atrium (LA) to the left ventricle (LV). MA can be assessed by three-dimensional speckle-tracking echocardiography (3DSTE) respecting the cardiac cycle. The present study was designed to test whether repaired Tetralogy of Fallot (TOF) is associated with morphological and functional alterations of the MA. The role of the type of treatment (early total reconstruction vs. early palliation, late correction) was also assessed. Methods The study population consisted of 29 consecutive adults repaired TOF patients (mean age: 35.4±15.5 years, 18 men), from which 13 patients underwent early total reconstruction (etrTOF), while 16 patients were firstly palliated and later corrected (pcTOF). Their data were compared to that of 76 age- and gender-matched healthy controls (mean age: 35.9±7.6 years, 33 men). All repaired TOF patients and controls were assessed by two-dimensional (2D) Doppler echocardiography and 3DSTE. Results Dilated end-systolic and end-diastolic MA diameter, area and perimeter and reduced MA fractional area change and MA fractional shortening could be demonstrated in repaired TOF patients as compared to controls. Increased body surface area-indexed end-diastolic and end-systolic MA diameter and perimeter could be demonstrated in pcTOF patients as compared to that of etrTOF cases. Conclusions MA enlargement and functional impairment could be detected in adult patients with repaired TOF regardless of the type of correction. However, pcTOF patients have worse results.
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Affiliation(s)
- Attila Nemes
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Árpád Kormányos
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Kálmán Havasi
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Zsolt Kovács
- Department of Cardiology, Szent Rókus Hospital, Baja, Hungary
| | - Péter Domsik
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - István Hartyánszky
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nóra Ambrus
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Tamás Forster
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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Cheung YF, Yu CKM, So EKF, Li VWY, Wong WHS. Atrial Strain Imaging after Repair of Tetralogy of Fallot: A Systematic Review. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1896-1908. [PMID: 31153717 DOI: 10.1016/j.ultrasmedbio.2019.04.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/28/2019] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
We performed a systematic review of the literature on assessment of right atrial (RA) and left atrial (LA) deformation by myocardial strain imaging in patients with repaired tetralogy of Fallot. Ten studies with a total of 536 adolescent and adult patients were included, of which 5 evaluated RA deformation, 2 studied LA deformation and 3 assessed deformation of both atria. Seven studies used speckle tracking echocardiography, 2 employed tissue Doppler imaging and 1 applied cardiac magnetic resonance feature tracking. Main findings were (i) reduced regional and/or global RA and LA strain and strain rate consistent with reduced conduit, reservoir and contractile function of the two atria in patients; (ii) associations between RA and LA deformation indices suggestive of atrial-atrial interaction; and (iii) relationships between RA deformation and indices of right ventricular systolic and diastolic function. The lack of data on prognostic value of atrial strain is an important knowledge gap.
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Affiliation(s)
- Yiu-Fai Cheung
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
| | - Clement K M Yu
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China
| | - Edwina K F So
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China
| | - Vivian W Y Li
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China
| | - Wilfred H S Wong
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China
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Nemes A, Kormányos Á, Domsik P, Kalapos A, Ambrus N, Lengyel C, Forster T. Normal reference values of right atrial strain parameters using three-dimensional speckle-tracking echocardiography (results from the MAGYAR-Healthy Study). Int J Cardiovasc Imaging 2019; 35:2009-2018. [PMID: 31300935 PMCID: PMC6805961 DOI: 10.1007/s10554-019-01655-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 06/19/2019] [Indexed: 01/08/2023]
Abstract
Classic echocardiographic methodologies offer limited opportunities in assessing right atrial (RA) morphology and function. Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is a novel imaging method with objective 3D capability in assessing volumetric and functional properties of heart chambers. Normal reference values of different 3DSTE-derived RA strains are not available, therefore the aim of this prospective study was to establish these parameters in healthy subjects. The present study comprised 295 healthy volunteers, from which 110 were excluded due to inadequate image quality. The final population consisted of 185 healthy subjects in the present study (mean age: 32.1 ± 12.2 years, 89 males). Complete two-dimensional echocardiography and 3DSTE have been performed in all cases. While radial strain (RS) does not change significantly over the years in males, in female subjects it increases with age most significantly between at the age of 40–49, and it starts to decline at the age of 50 in females. While females have higher circumferential (CS) and area (AS) strain values, CS and AS decrease with age in both gender. While LS remains almost unchanged in females until ages 40–49 years with a decline above the age of 50, it decreases over the decades in males. 3D strain (3DS) increases with age in both gender, but almost doubles in females in older ages. Specific pattern of strains at atrial contraction could also be demonstrated. 3DSTE-derived RA normal reference values with age-, gender-dependency and regional values are demonstrated in a healthy population.
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Affiliation(s)
- Attila Nemes
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Semmelweis Street 8, P.O. Box 427, Szeged, 6725, Hungary.
| | - Árpád Kormányos
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Semmelweis Street 8, P.O. Box 427, Szeged, 6725, Hungary
| | - Péter Domsik
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Semmelweis Street 8, P.O. Box 427, Szeged, 6725, Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Semmelweis Street 8, P.O. Box 427, Szeged, 6725, Hungary
| | - Nóra Ambrus
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Semmelweis Street 8, P.O. Box 427, Szeged, 6725, Hungary
| | - Csaba Lengyel
- 1st Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Tamás Forster
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Semmelweis Street 8, P.O. Box 427, Szeged, 6725, Hungary
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Havasi K, Ambrus N, Kalapos A, Forster T, Nemes A. The role of echocardiography in the management of adult patients with congenital heart disease following operative treatment. Cardiovasc Diagn Ther 2019; 8:771-779. [PMID: 30740324 DOI: 10.21037/cdt.2018.09.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Treatment of congenital heart diseases has significantly advanced over the last few decades. Due to the continuously increasing survival rate, there are more and more adult patients with congenital heart diseases and these patients present at the adult cardiologist from the paediatric cardiology care. The aim of the present review is to demonstrate the role of echocardiography in some significant congenital heart diseases.
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Affiliation(s)
- Kálmán Havasi
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Centre, University of Szeged, Szeged, Hungary
| | - Nóra Ambrus
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Centre, University of Szeged, Szeged, Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Centre, University of Szeged, Szeged, Hungary
| | - Tamás Forster
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Centre, University of Szeged, Szeged, Hungary
| | - Attila Nemes
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Centre, University of Szeged, Szeged, Hungary
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Nemes A, Földeák D, Domsik P, Kalapos A, Kormányos Á, Borbényi Z, Forster T. Right Atrial Deformation Analysis in Cardiac Amyloidosis - Results from the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study. Arq Bras Cardiol 2018; 111:384-391. [PMID: 30133551 PMCID: PMC6173351 DOI: 10.5935/abc.20180150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 04/11/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Light-chain (AL) cardiac amyloidosis (CA) is characterized by fibril deposits, which are composed of monoclonal immunoglobulin light chains. The right ventricle is mostly involved in AL-CA and impairment of its function is a predictor of worse prognosis. OBJECTIVES To characterize the volumetric and functional properties of the right atrium (RA) in AL-CA by three-dimensional speckle-tracking echocardiography (3DSTE). METHODS A total of 16 patients (mean age: 64.5 ± 10.1 years, 11 males) with AL-CA were examined. Their results were compared to that of 15 age- and gender-matched healthy controls (mean age: 58.9 ± 6.9 years, 8 males). All cases have undergone complete two-dimensional Doppler and 3DSTE. A two-tailed p value of less than 0.05 was considered statistically significant. RESULTS Significant differences could be demonstrated in RA volumes respecting cardiac cycle. Total (19.2 ± 9.3% vs. 27.9 ± 10.7%, p = 0.02) and active atrial emptying fractions (12.1 ± 8.1 vs. 18.6 ± 9.8%, p = 0.05) were significantly decreased in AL-CA patients. Peak global (16.7 ± 10.3% vs. 31.2 ± 19.4%, p = 0.01) and mean segmental (24.3 ± 11.1% vs. 38.6 ± 17.6%, p =0.01) RA area strains, together with some circumferential, longitudinal and segmental area strain parameters, proved to be reduced in patients with AL-CA. Global longitudinal (4.0 ± 5.2% vs. 8.2 ± 5.5%, p = 0.02) and area (7.8 ± 8.1% vs. 15.9 ± 10.3%, p = 0.03) strains at atrial contraction and some circumferential and area strain parameters at atrial contraction were reduced in AL-CA patients. CONCLUSION Significantly increased RA volumes and deteriorated RA functions could be demonstrated in AL-CA.
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Affiliation(s)
- Attila Nemes
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged - Hungary
| | - Dóra Földeák
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged - Hungary
| | - Péter Domsik
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged - Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged - Hungary
| | - Árpád Kormányos
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged - Hungary
| | - Zita Borbényi
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged - Hungary
| | - Tamás Forster
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged - Hungary
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Nemes A, Domsik P, Kalapos A, Kormányos Á, Ambrus N, Forster T. Three-dimensional speckle-tracking echocardiography detects different patterns of right atrial dysfunction in selected disorders: a short summary from the MAGYAR-Path Study. Quant Imaging Med Surg 2018; 8:182-186. [PMID: 29675359 DOI: 10.21037/qims.2018.01.11] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The right atrium (RA) is the most under-evaluated heart chamber in the clinical practice. Three-dimensional (3D) speckle-tracking echocardiography (STE) merges the benefits of 3D echocardiography and STE: volumetric and strain assessment of the RA can be performed at the same time from the same digitally acquired 3D echocardiographic dataset with a special equipment using a virtual 3D model of the RA. A diagnostic focused study is under way at the Second Department of Medicine and Cardiology Center, University of Szeged, Hungary to assess 3D-STE-derived RA variables in different patient populations, which serves as a substudy of Motion Analysis of the heart and Great vessels bY three-dimensionAl speckle-tRacking echocardiography in Pathological cases (MAGYAR-Path) Study. The aim of the present review is to summarize these early results.
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Affiliation(s)
- Attila Nemes
- Second Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Péter Domsik
- Second Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Anita Kalapos
- Second Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Árpád Kormányos
- Second Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nóra Ambrus
- Second Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Tamás Forster
- Second Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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Mendes L, Cardim N. Right atrial function with speckle tracking echocardiography: Do we really need it? REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.repce.2017.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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13
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Right atrial function with speckle tracking echocardiography: Do we really need it? Rev Port Cardiol 2017; 36:901-904. [DOI: 10.1016/j.repc.2017.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Havasi K, Domsik P, Kalapos A, McGhie JS, Roos-Hesselink JW, Forster T, Nemes A. Left Atrial Deformation Analysis in Patients with Corrected Tetralogy of Fallot by 3D Speckle-Tracking Echocardiography (from the MAGYAR-Path Study). Arq Bras Cardiol 2017; 108:129-134. [PMID: 28327874 PMCID: PMC5344657 DOI: 10.5935/abc.20170004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 09/13/2016] [Indexed: 11/20/2022] Open
Abstract
Background Three-dimensional (3D) echocardiography coupled with speckle-tracking echocardiographic (STE) capability is a novel methodology which has been demontrated to be useful for the assessment of left atrial (LA) volumes and functional properties. There is increased scientific interest on myocardial deformation analysis in adult patients with corrected tetralogy of Fallot (cTOF). Objectives To compare LA volumes, volume-based functional properties and strain parameters between cTOF patients and age- and gender-matched healthy controls. Methods The study population consisted of 19 consecutive adult patients with cTOF in sinus rhythm nursing at the University of Szeged, Hungary (mean age: 37.9 ± 11.3 years, 8 men, who had repair at the age of 4.1 ± 2.5 years). They all had undergone standard transthoracic two-dimensional Doppler echocardiographic study extended with 3DSTE. Their results were compared to 23 age- and gender-matched healthy controls (mean age: 39.2 ± 10.6 years, 14 men). Results Increased LA volumes and reduced LA emptying fractions respecting cardiac cycle could be demonstrated in cTOF patients compared to controls. LA stroke volumes featuring all LA functions showed no differences between the 2 groups examined. LA global and mean segmental uni- and multidirectional peak strains featuring LA reservoir function were found to be diminished in adult patients with cTOF as compared to controls. Similarly to peak strains reduced global and mean segmental LA strains at atrial contraction characterizing atrial booster pump function could be demonstrated in cTOF patients as compared to controls. Conclusions Significant deterioration of all LA functions could be demonstrated in adult patients with cTOF late after repair.
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Affiliation(s)
- Kálmán Havasi
- 2nd Department of Medicine and Cardiology Center - Medical Faculty - Albert Szent-Györgyi Clinical Center - University of Szeged - Szeged - Hungary
| | - Péter Domsik
- 2nd Department of Medicine and Cardiology Center - Medical Faculty - Albert Szent-Györgyi Clinical Center - University of Szeged - Szeged - Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Center - Medical Faculty - Albert Szent-Györgyi Clinical Center - University of Szeged - Szeged - Hungary
| | - Jackie S McGhie
- Department of Cardiology - Erasmus MC - Rotterdam - The Netherlands
| | | | - Tamás Forster
- 2nd Department of Medicine and Cardiology Center - Medical Faculty - Albert Szent-Györgyi Clinical Center - University of Szeged - Szeged - Hungary
| | - Attila Nemes
- 2nd Department of Medicine and Cardiology Center - Medical Faculty - Albert Szent-Györgyi Clinical Center - University of Szeged - Szeged - Hungary
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Nemes A, Domsik P, Kalapos A, Gavallér H, Oszlánczi M, Forster T. Right atrial deformation analysis in isolated left ventricular noncompaction – insights from the three-dimensional speckle tracking echocardiographic MAGYAR-Path Study. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.repce.2016.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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16
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Nemes A, Domsik P, Kalapos A, Gavallér H, Oszlánczi M, Forster T. Right atrial deformation analysis in isolated left ventricular noncompaction – insights from the three-dimensional speckle tracking echocardiographic MAGYAR-Path Study. Rev Port Cardiol 2016; 35:515-21. [DOI: 10.1016/j.repc.2016.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/04/2016] [Accepted: 04/05/2016] [Indexed: 12/28/2022] Open
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