Quantitative assessment of contractile reserve of systemic right ventricle in post‐Senning children: Incorporating speckle‐tracking strain and dobutamine stress echocardiography

Abstract

Introduction: The systemic load on the right ventricle (RV) after Senning atrial switch leads to ventricular dysfunction. Quantitative assessment of RV contractile reserve is mandatory to anticipate the need for anti-fibrotic treatment. We aimed to quantitatively assess RV contractile reserve in Senning children by estimating speckle-based global longitudinal strain (GLS) during dobutamine stress echocardiography (DSE). Methods: This prospective study compared thirty-one post-Senning children (group I) and thirty controls (group II). In post-Senning children, echocardiographic RV systolic function using one-plane ejection fraction (RVEF), RV fractional area change (RVFAC), tricuspid annulus plane systolic excursion (TAPSE), its Z-score, and RVGLS were recorded at rest and peak DSE. Contractile reserve was defined as improvement >5% in RVEF, >2% in GLS, and/or to near normal TAPSE.

Timely Detection of Subclinical Heart Failure Among Children with D-Transposition of Great Arteries after Senning Operation: A Single Center Experience

“…Prompt timely diagnosis of subclinical RV failure post Senning helps to tailor the medical treatment post-operatively, improve the quality of life and increase the post-operative survival. RV GLS was reported to be an accurate parameter to assess RV function in Senning survivors (16,17). Our work provides more evidence to support the accuracy of RV GLS in assessment of RV function.…”

Multi‐modality imaging of the systemic right ventricle in congenital heart disease

“…In fact, corroborating evidence on the predictive role of sRVGLS indicates that it is the most powerful index of sRV function 22 and the only index allied with the functional capacity and detection of early subclinical sRV myocardial damage 31 . Additionally, it has been proved as a quantitative assessment parameter of contractile reserve during dobutamine stress echocardiography in TGA patients after Senning atrial switch 32 . An sRVGLS cutoff value of −14.2% to −16.3% has been associated with preserved sRV systolic function 13,17 .…”

“…31 Additionally, it has been proved as a quantitative assessment parameter of contractile reserve during dobutamine stress echocardiography in TGA patients after Sen-ning atrial switch. 32 An sRVGLS cutoff value of −14.2% to −16.3% has been associated with preserved sRV systolic function. 13,17 The main limitations of the method include the low temporal resolution (frame rate) and the image quality.…”