Development of right ventricular electromechanical dyssynchrony following surgical repair of tetralogy of Fallot in infants.
| Title: | Development of right ventricular electromechanical dyssynchrony following surgical repair of tetralogy of Fallot in infants. |
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| Authors: | McCrary AW; Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States.; Collins SD; Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States.; Spector ZZ; Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States.; Kropf PA; Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States.; Barker PCA; Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States.; Kisslo J; Divison of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC, United States.; Forsha DE; Division of Pediatric Cardiology, Division of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, MO, United States. |
| Source: | Frontiers in pediatrics [Front Pediatr] 2025 Jan 10; Vol. 12, pp. 1443924. Date of Electronic Publication: 2025 Jan 10 (Print Publication: 2024). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Frontiers Media SA Country of Publication: Switzerland NLM ID: 101615492 Publication Model: eCollection Cited Medium: Print ISSN: 2296-2360 (Print) Linking ISSN: 22962360 NLM ISO Abbreviation: Front Pediatr Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Lausanne : Frontiers Media SA, [2013]- |
| Abstract: | Background: In adolescents and adults with tetralogy of Fallot (TOF), right ventricle (RV) electromechanical dyssynchrony (EMD) due to right bundle branch block (RBBB) is associated with reduced exercise capacity and RV dysfunction. While the development of RBBB following surgical repair of tetralogy of Fallot (rTOF) is a frequent sequela, it is not known whether EMD is present in every patient immediately following rTOF. The specific timing of the onset of RBBB following rTOF therefore provides an opportunity to assess whether acute RBBB is associated with the simultaneous acquisition of EMD.; Methods: Transthoracic echocardiography with speckle tracking analysis for RV global longitudinal strain (GLS) and 12-lead ECG were performed prospectively on 20 infants following rTOF. Three apical RV views were obtained using analogous imaging planes to the standard LV views to provide a comprehensive evaluation. Regional RV GLS patterns were categorized as synchronous, EMD, or indeterminate. EMD was defined as an early-terminated septal contraction opposed by early stretch and post-systolic peak contraction in the activation delayed RV free wall. An indeterminate pattern was defined as a lack of fully synchronous contraction of all segments but not meeting criteria for EMD. Pre-rTOF echocardiograms and ECGs were analyzed to confirm the presence of synchronous contraction and a normal QRS pattern and duration prior to surgery.; Results: Twenty TOF infants (median age 87 days; 8 days from surgery to post-rTOF evaluation) demonstrated QRSd prolongation following rTOF (pre-rTOF 58 ± 9 ms; post-rTOF 97 ± 14 ms; p |
| Competing Interests: | The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. |
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| Contributed Indexing: | Keywords: dyssynchrony; electromechanical dyssynchrony; right bundle branch block; strain echocardiography; tetralogy of Fallot |
| Entry Date(s): | Date Created: 20250127 Latest Revision: 20250130 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11757878 |
| DOI: | 10.3389/fped.2024.1443924 |
| PMID: | 39867696 |
| Database: | MEDLINE |
Journal Article