DETERMINING THE FREQUENCY OF VENTRICULAR DYSFUNCTION IN ADULT CONGENITAL HEART DISEASE PATIENTS BY TISSUE DOPPLER IMAGING AND ITS RELATION WITH FUNCTIONAL CLASS

Abstract

Background: Left and right ventricular systolic and diastolic functions are contributors to the symptoms and prognosis in adults with congenital heart disease. Echocardiography is a simple tool to evaluate the ventricular function.<br />Tissue Doppler imaging (TDI) may be a good complement in adult congenital heart disease given the altered geometry of the ventricles.<br />Methods: Forty-seven consecutive patients (29 male, mean age=20±3 years) presenting to the Adult Congenital Heart Disease clinic were evaluated by conventional echocardiography and TDI to assess the right and left ventricular systolic and diastolic functions and their relation with subjective functional class (FC).<br />Results: Six (12.8%) patients had left ventricular ejection fraction (LVEF) <50%; eleven (23.4%) patients had moderate RV systolic dysfunction, and one (2.1%) patient had severe RV dysfunction. Those patients with at least FC II had a significantly lower LVEF (P=0.001) and RVEF (P=0.007) comparing with asymptomatic patients or those with FC I. By TDI, those who had RV Ea (early diastolic myocardial relaxation velocity)<Aa had a significantly higher FC (P=0.02), and those who had LV Em<8 had a higher FC; this relation, however, was not significant.<br />Conclusion: Left and right ventricular dysfunctions have significant correlations with FC in adult congenital heart diseases. TDI may improve conventional echocardiography in the assessment of the ventricular function.