Annular Atrioventricular Valve Area Dynamics in Patients with Hypoplastic Left Heart Syndrome and Right Atrial Isomerism: Insights Using Speckle-Tracking of the Atrioventricular Valve Annulus
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- Tsubura Masahiro
- Department of Cardiology, Shizuoka Children’s Hospital
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- Nii Masaki
- Department of Cardiology, Shizuoka Children’s Hospital
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- Takahashi Ken
- Department of Pediatrics and Adolescent Medicine, Juntendo University Hospital
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- Takigiku Kiyohiro
- Department of Cardiology, Nagano Children’s Hospital
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- Toyono Manatomo
- Department of Pediatrics, Akita University Hospital
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- Iwashima Satoru
- Department of Pediatrics, Chutoen General Medical Center
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- Inoue Nao
- Department of Pediatric Cardiology, Seirei Hamamatsu General Hospital
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- Ishigaki Mizuhiko
- Department of Cardiology, Shizuoka Children’s Hospital
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- Sato Keisuke
- Department of Cardiology, Shizuoka Children’s Hospital
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- Yoshimoto Jun
- Department of Cardiology, Shizuoka Children’s Hospital
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- Kim Sung-Hae
- Department of Cardiology, Shizuoka Children’s Hospital
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- Mitsushita Norie
- Department of Cardiology, Shizuoka Children’s Hospital
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- Sakamoto Kisaburo
- Department of Cardiovascular surgery, Shizuoka Children’s Hospital
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- Tanaka Yasuhiko
- Department of Cardiology, Shizuoka Children’s Hospital
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Description
<p>Background: Atrioventricular valve regurgitation (AVVR) has a notable impact on the prognosis of patients with hypoplastic left heart syndrome (HLHS) and right atrial isomerism (RAI).</p><p>Methods: The study population comprised two groups: (1) HLHS and RAI group: n=32 (HLHS=15, RAI=17), and (2) normal control group: n=53. X-plane images of apical four-chamber view and orthogonal plane cutting through the center of annulus were acquired using transthoracic matrix array probe. Speckle-tracking of the two opposing points on the annulus in four-chamber plane and orthogonal plane was performed, and the distances of respective opposing points were consecutively measured along the cardiac cycle. Atrioventricular valve (AVV) area dynamics were classified into three categories according to the areal change pattern during systole in the normal group: Type-1: area decreases during systole; Type-2: area increases during systole; and Type-3: no significant areal change. The HLHS and RAI groups were subdivided into two subgroups according to the grade of AVVR: low-grade AVVR and high-grade AVVR, and the annular dynamics were compared between the groups.</p><p>Results: Normal group was classified into the subgroups as follows: Type-1=22 (42%); Type-2=24 (45%); and Type-3=7 (13%). HLHS and RAI group was classified into the following subgroups: Type-1=4 (13%), Type-2=7 (24%), and Type-3=21 (65%). Type-3 was predominant in the HLHS and RAI groups (p<0.01). The subdivided groups were similarly classified into low-grade AVVR group (n=16) and high-grade AVVR group (n=16). Type-3 was predominant in the high-grade AVVR group (p<0.01).</p><p>Conclusions: In patients with single ventricle associated with tricuspid valve or common AVV, significant valve incompetence was observed in those with reduced annular dynamics, suggesting the importance of annular function in the patients.</p>
Journal
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- Journal of Pediatric Cardiology and Cardiac Surgery
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Journal of Pediatric Cardiology and Cardiac Surgery 4 (1), 1-8, 2020-03-01
Japanese Society of Pediatric Cardiology and Cardiac Surgery