Abstract 11640: Longitudinal Changes in Ventricular Torsion in Adolescents with Single-Ventricle Anatomy: Long Term Follow Up

• Published in: Circulation (New York, N.Y.) N.Y.), 2021-11, Vol.144 (Suppl_1), p.A11640-A11640
• Main Authors: Aly, Safwat, Mertens, Luc L, Friedberg, Mark K, Grosse-Wortmann, Lars, Dragulescu, Andreea
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.144.suppl_1.11640

BackgroundVentricular torsion is important in assessment of the systolic and diastolic function especially in single ventricle (SV) but is poorly studied. ObjectiveWe aimed to a) examine serial changes in SV torsion, and b) examine its association with CMR data and exercise performance. MethodsWe retrospectively studied SV patients after Fontan completion. Speckle-tracking echocardiography was used to evaluate serial changes in ventricular mechanics; strain, torsion, and untwist. CMR volumetric data and cardiopulmonary exercise data closest to echocardiograms were obtained. The most recent follow up echocardiographic and CMR data were compared to data before Fontan. Results45 SV patients (27 LV, 12 RV, and 6 co dominant) were studied. Demographics, echocardiographic, CMR, and exercise data are shown in table 1. Mean time at follow up echo from time of Fontan was 12.8 (10.6-16.6) years. Follow up echocardiograms showed reduced global longitudinal strain [-17.5(-6.5 to-19.5) vs -19.8 (-12 to -23%), p=0.01], circumferential strain [-15.7 (-8.4 to - 20.7) vs [-18.9 (-11.2 to -25.0), p=0.009], reduced torsion [5.5°/cm (-6.1 to 17.8) vs 8.1°/cm (-9.7 to18.5) vs, p=0.03], decreased apical rotation [6.5°/cm (-11.3 to 18.1) vs 5.1°/cm (-21.2 to 19.7), p=0.02] with no significant change in basal rotation compared to the echo at time of Fontan. Single RV had lower net torsion compared to single LV [2.7°/cm (-2.5.1 to 13.1) vs 6.1°/cm (-6.3 to 19.5) vs, p=0.03]. Mean interval between echocardiograms and exercise testing and CMR were 3.5±2.2 and 5.6±1.8 months respectively. Torsion and untwist rates correlated with peak oxygen consumption (r=0.64, -0.41, p=0.01, 0.04 respectively) but did not correlate with ventricular volumes or ejection fractions. ConclusionIn long term follow up post Fontan, SV torsion is decreased due to decreased apical rotation, worse in single RV, and is associated with decreased exercise capacity.