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Myocardial strain-curve deformation patterns after Fontan operation.
Schäfer, Michal; Mitchell, Max B; Frank, Benjamin S; Barker, Alex J; Stone, Matthew L; Jaggers, James; von Alvensleben, Johannes C; Hunter, Kendall S; Friesen, Richard M; Ivy, D Dunbar; Jacobsen, Roni; Di Maria, Michael V.
Afiliación
  • Schäfer M; Division of Pediatric Cardiology, Children's Hospital Colorado, Heart Institute, University of Colorado Denver, Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO, USA. michal.schafer@cuanschutz.edu.
  • Mitchell MB; Division of Cardiothoracic Surgery, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA. michal.schafer@cuanschutz.edu.
  • Frank BS; Division of Cardiothoracic Surgery, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
  • Barker AJ; Division of Pediatric Cardiology, Children's Hospital Colorado, Heart Institute, University of Colorado Denver, Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO, USA.
  • Stone ML; Department of Radiology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
  • Jaggers J; Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
  • von Alvensleben JC; Division of Cardiothoracic Surgery, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
  • Hunter KS; Division of Cardiothoracic Surgery, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
  • Friesen RM; Division of Pediatric Cardiology, Children's Hospital Colorado, Heart Institute, University of Colorado Denver, Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO, USA.
  • Ivy DD; Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
  • Jacobsen R; Division of Pediatric Cardiology, Children's Hospital Colorado, Heart Institute, University of Colorado Denver, Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO, USA.
  • Di Maria MV; Division of Pediatric Cardiology, Children's Hospital Colorado, Heart Institute, University of Colorado Denver, Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO, USA.
Sci Rep ; 13(1): 11912, 2023 07 24.
Article en En | MEDLINE | ID: mdl-37488167
Myocardial deformation analysis by cardiac MRI (CMR) yielding global circumferential and longitudinal strain (GCS and GLS) is an increasingly utilized method to accurately quantify systolic function and predict clinical events in patients with Fontan circulation. The purpose of this study was to use principal component analysis (PCA) to investigate myocardial temporal deformation patterns derived from strain-time curves to learn about latent strain features beyond peak values. We conducted the study with specific attention to dominant single left or right ventricle (SLV and SRV) morphologies. Methods and Results: Patients remote from Fontan operation who underwent follow-up CMR were analyzed for standard volumetric and function hemodynamics including myocardial deformation parameters including GCS and GLS. We applied PCA to investigate in an unbiased fashion the strain-time curve morphology and to calculate patient specific shape scores. All variables were subjected to single variable Cox regression analysis to detect composite clinical outcome including death, heart transplant, protein losing enteropathy and plastic bronchitis. A total of 122 patients, (SLV = 67, SRV = 55) with a mean age of 12.7 years underwent comprehensive CMR analysis. The PCA revealed 3 primary modes of strain-curve variation regardless of single ventricle morphology and type of strain investigated. Principle components (PCs) described changes in (1) strain-time curve amplitude, (2) time-to-peak strain, and (3) post-systolic slope of the strain-time curve. Considering only SLV patients, GCS was only CMR variable predictive of clinical events (HR 1.46, p = 0.020). In the SRV group, significant CMR predictors of clinical events were derived indexed end-diastolic (HR 1.02, p = 0.023) and end-systolic (HR 1.03, p = 0.022) volumes, GCS (HR 1.91, p = 0.003) and its related first component score (HR 1.20, p = 0.005), GLS (HR 1.32, p = 0.029) and its third component score (HR 1.58, p = 0.017). CMR derived global strain measures are sensitive markers of clinical outcomes in patients with Fontan circulation, particularly in patients with the SRV morphology. Myocardial strain-time curve morphology specific to SLV and SRV patients inspired by unbiased PCA technique can further aid with predicting clinical outcomes.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Corazón / Procedimiento de Fontan Tipo de estudio: Prognostic_studies Límite: Child / Humans Idioma: En Revista: Sci Rep Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Corazón / Procedimiento de Fontan Tipo de estudio: Prognostic_studies Límite: Child / Humans Idioma: En Revista: Sci Rep Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido