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Ventricular and atrial mechanics and their interaction in patients with congenital scoliosis without clinical heart failure

Published online by Cambridge University Press:  12 September 2014

Shujuan Li ,
Junlin Yang ,
Ling Zhu ,
Yuese Lin ,
Xuandi Li ,
Yunquan Li ,
Zifang Huang  and
Huishen Wang
Shujuan Li
Affiliation:
Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Junlin Yang
Affiliation:
Department of Spinal Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Ling Zhu
Affiliation:
Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Yuese Lin
Affiliation:
Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Xuandi Li
Affiliation:
Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Yunquan Li
Affiliation:
Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Zifang Huang
Affiliation:
Department of Spinal Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Huishen Wang*
Affiliation:
Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
*
Correspondence to: Professor H. Wang, Department of Paediatric Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, 58 2nd Zhongshan Road, Guangzhou, China. Tel: +86 020 87332200 8835; Fax: +86 020 87330808; E-mail: huishenwang@hotmail.com
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Abstract

Objectives: This study sought to evaluate left ventricular, right ventricular, and left atrial mechanics and their interactions in patients with congenital scoliosis without clinical heart failure. Methods: A total of 23 patients with a median age of 14 years and a median Cobb’s angle of 61° were studied. Ventricular and atrial myocardial deformation was measured using speckle tracking echocardiography. The results of the patients were compared with 22 controls. Results: Compared with controls, the patients had a significantly greater annular a velocity (p=0.04) and lower e/a ratio (p=0.03); the left ventricular deformation significantly decreased in radial global (p=0.04) and segmental systolic strain and early diastolic strain rate (p=0.03); the left atrial deformation showed a significantly lower positive strain (p=0.02), greater negative strain (p=0.01), and active contractile strain rate (p=0.01). For the patients, the Cobb’s angle was negatively correlated with the left ventricular global radial systolic strain (r=−0.65, p=0.001), left atrial positive strain (r=−0.68, p<0.001), and the left atrial negative strain was positively correlated with the left ventricular circumferential late diastolic strain rate (r=0.46, p=0.01). The left atrial conduit strain rate was positively correlated with the left ventricular circumferential early diastolic strain rate (r=0.42, p=0.03). The left atrial active contractile strain rate was positively correlated with the left ventricular longitudinal late diastolic strain rate (r=−0.4, p=0.03). Conclusions: Impaired left ventricular and altered left atrial mechanics occur relatively early in patients with congenital scoliosis, and are correlated with the severity of their scoliosis. Our findings provide evidence of preclinical heart dysfunction in patients with this disorder.

Keywords

Congenital scoliosisventricular mechanicsatrial mechanicsinteractionspeckle tracking echocardiography
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 5 , June 2015 , pp. 976 - 983
Copyright
© Cambridge University Press 2014 

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References

1. Beals, RK, Robbins, JR, Rolfe, B. Anomalies associated with vertebral malformations. Spine 1993; 18: 1329–1332.Google Scholar
2. Basu, PS, Elsebaie, H, Noordeen, MH. Congenital spinal deformity: a comprehensive assessment at presentation. Spine 2002; 27: 2255–2259.CrossRefGoogle ScholarPubMed
3. Doi, T, Harimaya, K, Matsumoto, Y, Iwamoto, Y. Aortic location and flat chest in scoliosis: a prospective study. Fukuoka Igaku Zasshi 2011; 102: 14–19.Google Scholar
4. Hungate, RG, Newman, B, Meza, MP. Left mainstem bronchial narrowing: a vascular compression syndrome? Evaluation by magnetic resonance imaging. Pediatr Radiol 1998; 28: 527–532.Google Scholar
5. Donnelly, LF, Bisset, GS 3rd, McDermott, B. Anomalous midline location of the descending aorta: a cause of compression of the carina and left mainstem bronchus in infants. AJR Am J Roentgenol 1995; 164: 705–707.Google Scholar
6. Bowen, RE, Scaduto, AA, Banuelos, S. Decreased body mass index and restrictive lung disease in congenital thoracic scoliosis. J Pediatr Orthop 2008; 28: 665–668.Google Scholar
7. McPhail, GL, Howells, SA, Boesch, RP, et al. Obstructive lung disease in common in children with syndromic and congenital scoliosis: a preliminary study. J Pediatr Orthop 2013; 33: 781–785.CrossRefGoogle ScholarPubMed
8. Arlet, V, Odent, T, Aebi, M. Congenital scoliosis. Eur Spine J 2003; 12: 456–463.Google Scholar
9. Cobb, JR. Outline in the study of scoliosis. Instr Course Lect 1948; 5: 261–275.Google Scholar
10. Chow, PC, Liang, XC, Cheung, EW, Lam, WW, Cheung, YF. New two-dimensional global longitudinal strain and strain rate imaging for assessment of systemic right ventricular function. Heart 2008; 94: 855–859.Google Scholar
11. Cheung, EW, Liang, XC, Lam, WW, Cheung, YF. Impact of right ventricular dilation on left ventricular myocardial deformation in patients after surgical repair of tetralogy of Fallot. Am J Cardiol 2009; 104: 1264–1270.Google Scholar
12. Buckberg, G, Hoffman, JI, Mahajan, A, Saleh, S, Coghlan, C. Cardiac mechanics revisited: the relationship of cardiac architecture to ventricular function. Circulation 2008; 118: 2571–2587.Google Scholar
13. Debonnaire, P, Leong, DP, Witkowski, TG, et al. Left atrial function by two-dimensional speckle-tracking echocardiography in patients with severe organic mitral regurgitation: association with guidelines-based surgical indication and postoperative (long-term) survival. J Am Soc Echocardiogr 2013; 26: 1053–1062.Google Scholar
14. Khoo, NS, Smallhorn, JF, Kaneko, S, Kutty, S, Altamirano, L, Tham, EB. The assessment of atrial function in single ventricle hearts from birth to Fontan: a speckle tracking study by using strain and strain rate. J Am Soc Echocardiogr 2013; 26: 756–764.Google Scholar
15. Day, GA, Upadhyay, SS, Ho, EK, Leong, JC, lp, M. Pulmonary functions in congenital scoliosis. Spine 1994; 19: 1027–1031.Google Scholar
16. Swank, SM, Winter, RB, Moe, JH. Scoliosis and cor pulmonale. Spine 1982; 7: 343–354.Google Scholar
17. Li, S, Yang, J, Li, Y, et al. Right ventricular function impaired in children and adolescents with severe idiopathic scoliosis. Scoliosis 2013; 8: 1–7.Google Scholar
18. Primiano, FP Jr, Nussbaum, E, Hirschfeld, SS, et al. Early echocardiographic and pulmonary function findings in idiopathic scoliosis. J Pediatr Orthop 1983; 3: 475–481.Google Scholar
19. Liang, JQ, Qiu, GX, Shen, JX, et al. A retrospective study of echocardiographic cardiac function and structure in adolescents with congenital scoliosis. Chin Med J 2009; 122: 906–910.Google Scholar
20. Leitman, M, Lysyansky, P, Sidenko, S, et al. Two-dimensional strain-a novel software for real-time quantitative echocardiographic assessment of myocardial function. J Am Soc Echocardiogr 2004; 17: 1021–1029.Google Scholar
21. Prada, CE, Sellars, EA, Spaeth, CG, Kline-Fath, BM, Crombleholme, TM, Hopkin, RJ. Severe cervical scoliosis in the fetus. Prenat Diagn 2011; 31: 1198–1202.Google Scholar
22. Mondillo, S, Galderisi, M, Mele, D, et al. Speckle-tracking echocardiography: a new technique for assessing myocardial function. J Ultrasound Med 2011; 30: 71–83.CrossRefGoogle Scholar
23. Blessberger, H, Binder, T. NON-invasive imaging: two dimensional speckle tracking echocardiography: basic principles. Heart 2010; 96: 716–722.Google Scholar