Assessment Of Right Ventricular Systolic Function In Patients With Repaired Tetralogy Of Fallot By Echocardiography

Objective:The purpose of this study was to evaluate right ventricular global and segmental systolic function after radical surgery in patients with tetralogy of Fallot(TOF)by echocardiography,explore the relationship between right ventricular systolic function and pulmonary regurgitation,surgical approach,age of surgery,and follow-up time.Metheds:There were 22 patients with after repaired of tetralogy of Fallot in the experimental group,and 25 healthy.The experimental group was divided into mild-moderate PR group and severe PR group according to the degree of PR,meanwhile the trans-annulus patch group and non-trans-annulus patch group on the basis of the operation method.The conventional two-dimensional ultrasound measurements of right ventricular systolic function was measured,global longitudinal peak systolic strain(GLS)and global longitudinal peak systolic strainrate(GLSR),strain(ε)and strain rate(SR)of the right ventricular free wall and ventricular for septal basal,middle,apical segments by speckle tracking echocardiography(STE)were recoreded.Results:1.There was no significant difference in the general situation between the experimental group and the control group.2.The GLS,GLSR of right ventricular and?,SR of segments(expect the SR of right ventricular free wall apical segment)were decreased,the index of Tei increased compared with healthy(P<0.05),the basel,middle of right ventricular free wall reduced significantly(P<0.001).3.Compared with the mild-moderate PR group,the decrease of GLS and GLSR in the severe PR group was statistically significant(P=0.014,P=0.001).There was a correlation between the pulmonary regurgitation jet width/pulmonary valve ring diameter(PJ/PVD)regurgitation and GLSR(r_s=0.631,P=0.002).4.Compared with the non-trans-annulus patch group,the decrease of GLSR in the trans-annulus patch group was statistically significant(P=0.003).There was a correlation between the surgical method and GLSR(r_s=0.599,P=0.003).5.Compared with the non-trans-annulus patch group,the increase of PJ/PVD in trans-annulus patch group was statistically significant(P=0.003).There was a correlation between the surgical method and RJ/PVD(r_s=0.620,P=0.002).6.There was no correlation between GLS,GLSR of right ventricular and operative time and postoperative time.Conclusions:The right ventricular systolic function of patients with repaired of tetralogy of Fallot is lower than that of normal people and the basal and middle of free wall are significantly reduced.Surgical method affects PR degree.PR and surgical method affect postoperative right ventricular function.GLRS is a more sensitive indicator of right ventricular systolic function.