Rima SILEIKIENE, Jolanta VASKELYTE, Vaida MIZARIENE, Irena NEDZELSKİENE, Renaldas JURKEVICIUS, Viktorija SILEIKYTE, Rimentas KEVALAS

Speckle tracking derived left and right ventricular strain, strain rate and left ventricular rotation in children after slow pathway ablation

Amaç: Bu çalışmanın amacı, çocuklarda atriyoventriküler yavaş iletim yolu radyofrekans ablasyonu son-rası geç takip döneminde sol ve sağ ventiküler gerilme (strain), strain hızı ve sol ventrikül rotasyonunu değerlendirmektir.Gereç ve yöntemler: Radyofrekans ablasyonu uygulanan 22 çocuk ve sağlıklı 15 çocukta sol ve sağ ventriküler strain, strain hızı, sol ventrikül rotasyonu, rotasyonal hız ve burkulma (twist) “Specle tracking” ekokardiyografi ile değerlendirildi.Bulgular: Konvansiyonel ekokradiyografi ile iki grup arasında sol ve sağ ventrikül parametreleri bakımın-dan; sol atriyal hacim (28.0±8.7 ml kontrol grubunda ve 37.3±13.9 ml radyofrekans ablasyon grubunda, p=0.024) ve sağ atriyal hacim (sırasıyla, 16.0±6.7 ml ve 21.5±8.5 ml, p=0.047) ve bunların sol (16.7±6.0 ml/m2 ve 26.3± 9.8 ml/m2, p=0.002) ve sağ (16.0± 6.6 ml/m2 ve 21.5±8.5 ml/m2, p=0.05) indekslerinin radyofrekans ablasyonu grubunda daha yüksek olması (p=0.023) dışında, anlamlı farklılık yoktu (p>0.05). Bölgesel ve global strain’den elde edilen “Spackle tracking” sistolik ve diyastolik sol ve sağ ventriküler strain hızı, sol ventriküler rotasyon ve rotasyonal hız radyofrekans ablasyon grubu ile kontrol grubu ara-sında anlamlı farklılık göstermedi (p>0.05).Sonuç: Speckle tracking ekokardiyografi atriyoventriküler düğüm yavaş yoluna radyofrekans ablasyonu uygulanmış çocuklarda sol ve sağ ventriküler bölgesel ve global uzun ve kısa eksen fonksiyonlarında herhangi bir bozulmayı göstermedi.

Çocuklarda yavaş yol ablasyonu sonrası “Speckle tracking” ile elde edilen sol ve sağ ventriküler “strain”, “strain” hızı ve sol ventrikül rotasyonu

Objectives: Aim of the study was to assess left and right ventricular strain, strain rate and left ventricular rotation in children at late follow-up after atrioventricular node slow pathway radiofrequency ablation.Materials and methods: Left and right ventricular strain, strain rate, left ventricular rotation, rotational ve-locity and twist were assessed using the speckle tracking echocardiography in 22 children who underwent radiofrequency ablation of slow pathway and in 15 healthy control children.Results: There were no significant differences in conventional echocardiographic left and right ventricular parameters between the two groups (p>0.05), except left atrial volume (28.0±8.7 ml in control group vs. 37.3±13.9 ml in radiofrequency ablation group, p=0.024) and right atrial volume (16.0±6.7 ml vs. 21.5±8.5 ml, respectively, p=0.047) and their left (16.7±6.0 ml/m2 vs. 26.3± 9.8 ml/m2, p=0.002, respectively) and right (16.0± 6.6 ml/m2 vs. 21.5±8.5 ml/m2, respectively, p=0.05) indices that were significantly higher in radiofrequency ablation group. Speckle tracking imaging derived regional and global strain, systolic and diastolic left and right ventricular strain rate as well as left ventricular rotation, rotational rate did not differ between the radiofrequency ablation group and controls (p>0.05). Left ventricular twist was comparable between the radiofrequency ablation group and controls (p>0.05).Conclusions: Speckle tracking echocardiography did not revealed any deterioration of regional and global long and short axis function of the left and right ventricles in children, who underwent atrioventricu-lar node slow pathway radiofrequency ablation.

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1. Kugler JD, Danford DA, Houston KA, Felix G. Pediatric radiofrequency catheter ablation registry success, fluoroscopy time, and complication rate for supraventricular tachycardia: Comparison of early and resent eras. J Cardiovasc Electrophysiol 2002;13:336-341.
2. Becker M, Bilke E, Kühl H, et al. Analysis of myocardial deformation based on pixel tracking in 2D echocardiographic images allows quantitative assessment of regional left ventricular function. Heart 2006;92:1102-1108.
3. Lindqist P, Calcutteea A, Henein M. Echocardiography in assessment of right heart function. Eur J Echocardiogr 2008;9:225-34.
4. Marwick TH, Yu ChM, Sun JP. Myocardial Imaging: Tissue Doppler and Speckle Tracking. Blackwell Futura, 2007.
5. Torrent-Guasp F, Kocica MJ, Corno AF, et al. Towards new understanding of the heart structure and function. Eur J Cardiothorac Surg 2005;27:191-201.
6. Lang RM, Biering M, Devereux RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005;18:1440-1463.
7. Sengupta PP, Krishnamoorthy VK, Korinek J, Narula J, Vannan MA, Lester SJ. Left ventricular form and function revisited: applied translation science to cardiovascular ultrasound imaging. J Am Soc Echocardiogr 2007;20:539-551.
8. Helle-Valle T, Crosby J, Edvardsen T, et al. New noninvasive method for assessment left ventricular rotation: Speckle tracking echocardiography. Circulation 2005;112:3149-3156.
9. Feigenbaum H, Armstrong W, Ryan T. Feigenbaum's Echocardiography. 6th ed. Philadelphia: Lippincott Williams and Wilkins, 2005.
10. Notomi Y, Lysyasky P, Setser RM, et al. Measurement of ventricular torsion by two-dimensional speckle tracking imaging. J Am Coll Cardiol 2005;45:2034-41.
11. Takeuchi M, Nakai H, Kokumai M, Nishikage T, Otani SH, Lang RM. Age related changes in left ventricular twist assessed by two-dimensional speckle- tracking imaging. J Am Soc Echocardiogr 2006;19:1077-1084.
12. Ericson CC, Walsh EP, Triedman JK, Saul JP. Efficacy and safety of radiofrequency ablation in infants and young children _____ 18 months of age. Am J Cardiol 1994;74:944-947.
13. Kammeraad JA, Sreeram N, van Driel V, Oliver R, Balaji S. Is routine echocardiography valuable after uncomplicated catheter ablation in children? Cardiol Young 2004;14:386-388.
14. Mukherjee R, Parkhurst AM, Mingoia JT, et al. Myocardial remodeling after discrete radiofrequency injury: effects of tissue inhibitor of matrix metalloproteinase -1 gene deletion. Am J Physiol Heart Circ Physiol 2004;286:1242-1247.
15. Saul JP, Hulse JE, Papagiannis J, van Praagh R, Walsh EP. Late enlargement of radiofrequency lesions in infant lambs. Implications for ablation procedures in small children. Circulation 1994;90:492-499.
16. Dandel M, Hetzer R. Echocardiographic strain and strain rate imaging - Clinical applications. Int J Cardiol 2008;10:1016-30.
17. Galderisi M, Mondillo S. Echocardiography in clinical practice. One Way S.r.l. 2007.
18. Dell`Italia LJ. The right ventricle: anatomy, physiology, and clinical importance. Curr Probl Cardiol 1991;16:653-720.
19. Busadori C, Moreo A, Donato M Di, et al. A new 2D-based method for myocardial velocity strain and strain rate quantification in a normal adult and paediatric population: assessment of reference values. Cardiovascular Ultrasound 2009;7:8-19.
20. Lorch SM, Ludomirsky A, Singh GK. Maturation and growth-related changes in left ventricular longitudinal strain and strain rate measured by two-dimensional speckle tracking echocardiography in healthy pediatric population. J Am Soc Echocardiogr 2008;21:1207-1215.
21. Phan TT, Shivu GN, Abozguia Kh, Gnanadevan M, Ahmed I, Frenneaux M. Left venricular torsion and strain patterns in heart failure with normal ejection fraction are similar to age-related changes. Eur J Echocardiography 2009;10:793-800.
22. Notomi Y, Srinath G, Shiota T, et al. Maturation and adaptive modulation of left ventricular torsional biomechanics: Doppler tissue imaging observation from infancy to adulthood. Circulation 2006;113:2534-2541.
23. Thomas JD, Popovic ZB. Assessment of Left Ventricular Function by Cardiac Ultrasound. J Am Coll Cardiol 2006;48:2012-2025.