Systemic ventricular strain and torsion are predictive of elevated serum NT-proBNP in Fontan patients: a magnetic resonance study

• Published in: Quantitative imaging in medicine and surgery 2020-02, Vol.10 (2), p.485-495
• Main Authors: Hu, Li-Wei, Liu, Xin-Rong, Wang, Qian, Barton, Gregory P, Ouyang, Rong-Zhen, Sun, Ai-Min, Guo, Chen, Han, Tong-Tong, Yao, Xiao-Fen, François, Christopher J, Zhong, Yu-Min
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2223-4292; 2223-4306
• DOI: 10.21037/qims.2020.01.07

This study aimed to investigate the associations between cardiac strain, cardiac torsion, ventricular volumes, and ventricular ejection fraction, with N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in Fontan patients who were age- and gender-matched with healthy control subjects. Cardiovascular magnetic resonance (CMR) studies performed in 22 (15 male, 7 female) patients with single-ventricle physiology (all morphological left ventricles) palliated with Fontan and 17 (10 male, 7 female) age- and gender-matched healthy children volunteers were retrospectively analyzed. Serum NT-proBNP levels were obtained in Fontan subjects. Standard post-processing of CMR images included systemic ventricular end-diastolic and end-systolic volumes, stroke volume, cardiac mass, atrioventricular regurgitation, and ejection fraction. CMR tissue tracking (TT) software was used to quantify global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) and torsion of the systemic ventricle. Pearson and Spearman correlation coefficients were used in comparisons of correlations between NT-proBNP and functional parameters in repair Fontan patients. Intra-observer and inter-observer variability of CMR strain and torsion values were determined from 10 randomly selected Fontan subjects and 10 randomly selected control subjects. GLS was significantly lower in Fontan patients than in control subjects (-15.19±2.94 -19.97±1.70; P