Pan African Medical Journal
Journal / Pan African Medical Journal / Vol. 38 No. 1 (2021) / Articles

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Published:

Jan 13, 2021

Keywords:

Coronary reimplantation; arterial switch operation; speckle-tracking echocardiography; ventricular function

Issue

Vol. 38 No. 1 (2021)

Section

Articles

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Salma Charfeddine

Cardiology Department, Hedi Chaker University Hospital, University of Medicine of Sfax, Sfax, Tunisia

Dorra Abid

Cardiology Department, Hedi Chaker University Hospital, University of Medicine of Sfax, Sfax, Tunisia

Rania Hammami

Cardiology Department, Hedi Chaker University Hospital, University of Medicine of Sfax, Sfax, Tunisia

Rania Gargouri

Cardiology Department, Hedi Chaker University Hospital, University of Medicine of Sfax, Sfax, Tunisia

Leila Abid

Cardiology Department, Hedi Chaker University Hospital, University of Medicine of Sfax, Sfax, Tunisia

Faten Triki

Cardiology Department, Hedi Chaker University Hospital, University of Medicine of Sfax, Sfax, Tunisia

Samir Kammoun

Cardiology Department, Hedi Chaker University Hospital, University of Medicine of Sfax, Sfax, Tunisia

Abstract

Introduction: reduced exercise capacity, coronary artery abnormalities and reversible myocardial ischemia have been demonstrated after arterial switch operation (ASO) and coronary reimplantation. Despite this, indices of systolic function, assessed by standard and doppler echocardiography, are within the normal range. The aim of this study was to highlight the long-term changes in myocardial function following coronary reimplantation using Doppler and speckle-tracking imaging (STI) echocardiography.

Methods: this observational case control study included 36 patients and 20 gender and age-matched healthy controls. A group study was performed using patients who were followed for at least 6 months after the operation and who visited the pediatric cardiology outpatient between October 2015 and May 2016. Systolic and diastolic parameters, left ventricle (LV) and right ventricle (RV) myocardial performance were assessed in each group.

Results: the LV global peak strain parameters revealed a significant decrease in the longitudinal and circumferential strain components. The LV global longitudinal strain (GLS) values were lower in both groups of operated patients than controls (-19.9 ± 2.2% (group 1) versus -20.9 ± 1.6% (group 2) versus -22.9 ± 2.3% (group 3), p<0.001). The patients with coronary reimplantation had the lowest values. The LV global circumferential strain was also decreased in the group 1 patients as compared with the 2 other groups (-16.6 ± 4.1% (group 1) versus -19.4 ± 3.9% (group 2) versus -19.8 ± 4.0% (group 3), p<0.001).

Conclusion: although global LV function, assessed with conventional echocardiographic parameters, was normal, the 2D-STI analysis showed slight but significant decrease in the global and segmental longitudinal and circumferential LV strain during the long-term follow-up after coronary arteries reimplantation.

Journal Identifiers

eISSN: 1937-8688