[III-P-015] The assessment of atrial function in single ventricle circulation after Fontan operation using two-dimensional speckle tracking echocardiography
Keywords:echocardiography, strain, atrial funtion
Background: The atrial function in single ventricle physiology after Fontan operation is not unclear. Purpose: The aim of this study is to elucidate the atrial function after Fontan operation using two-dimensional speckle tracking echocardiography. Methods: 31 patients after Fontan operation (age: median 10, 5 to 15 years, HLHS: 10 pts; TA: 9; SRV: 6; PPA: 6) were enrolled in this study. We used Vivid 7 or 9 (GE Medical System) and EchoPac as a PC workstation for assessing the atrium with speckle tracking echocardiography. We measured the atrial reservoir （ε res）, conduit （ε con） and active（ε act）strain and ε act/ ε res ratio in the acquired 4ch views. Findings were compared with left atrium of age matched 20 healthy children. Result: Atrial ε res and ε con strain after Fontan were significantly decreased compared with healthy control, respectively (24.5±7.8 vs 42.0±9.8, p＜0.0001, 14.3±6.1 vs 31.9±7.4, p＜0.0001). While, εact strain did not different between two groups(14.3±6.1 vs 31.9±7.4, ns). Thus, ε act/ε res ratio was significant increased after Fontan (0.42±0.17 vs 0.23±0.06, p＜0.0001). Atrial ε res strain well correlated with ventricular systolic longitudinal strain (r=0.52, p＜0.001), as ε con strain correlated with ventricular diastolic longitudinal strain rate (r=0.73, p＜0.0001). Conclusion: After Fontan operation, the atrial reservoir and conduit function are deteriorated, while, active atrial contraction is predominant. The atrial low compliant state would be related with ventricular performance.