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Abnormal left atrial compliance is associated with a history of life-threatening arrhythmia in corrected Tetralogy of Fallot
Open accessAbstract
Objectives: The objectives of this study were to examine left atrial (LA) function and compliance using two-dimensional (2D) strain analysis in adult patients with corrected Tetralogy of Fallot (c-ToF) and to investigate the relationships between LA function and patient characteristics, especially history of life-threatening arrhythmia (h-LTA). Methods: Fifty-one c-ToF patients (34 males; age, 39 ± 15 years; h-LTA, n = 13) were included in this retrospective monocenter study. In addition to a 2D standard echocardiography examination, 2D strain analysis was performed to assess left ventricular (LV) and LA functions, including peak-positive LA strain (LAS—reservoir function) and LA compliance [defined as the ratio LAS/(E/Ea)]. Results: Patients with h-LTA were older and exhibited a longer QRS duration. LV ejection fraction, LAS and LA compliance were significantly lower in the group of patients with h-LTA. Indexed LA and RA volumes, RV end-diastolic area was significantly higher and RV fractional area change significantly lower in the h-LTA group. LA compliance was the best echocardiographic predictor for h-LTA (AUC: 0.839; p < 0.001). Moderate inverted correlations were found between LA compliance and age and QRS duration. Among the echocardiographic parameters, LA compliance was moderately inversely correlated with RV end-diastolic area (r = −0.40, p = 0.01). Conclusion: We documented abnormal LAS and LA compliance values in adult c-ToF patients. Further study is needed to determine how best to incorporate LA strain, particularly LA compliance, into multiparametric predictive models for LTA in c-ToF patients.
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Different studies have observed that the mechanics of both the left atrium and right atrium are impaired in the TOF population.
“Finally, different studies have observed that the mechanics of both the left atrium (LA) and right atrium (RA) are impaired in this population [22,23,24].”
From Multimodality imaging assessment of tetralogy of Fallot: From diagnosis to long-term follow-up (2023) · cites this paper as [23]
The Discussion section, “Left atrial mechanics and function after ToF repair” (page unavailable), reports impaired left atrial strain in patients with corrected Tetralogy of Fallot and says this agrees with previous studies. It discusses right atrial dilation and dysfunction as a possible consequence of right ventricular disease, but does not establish that right atrial mechanics were observed to be impaired alongside left atrial mechanics. (LLM, conf=0.83)
Experimental — accuracy not yet measuredAn association has been identified between abnormal left and right atrial compliance and a history of life-threatening arrhythmia in individuals with corrected TOF.
“In particular, an association has been identified between abnormal left and right atrial compliance and a history of life-threatening arrhythmia in individuals with corrected TOF [23,24].”
From Multimodality imaging assessment of tetralogy of Fallot: From diagnosis to long-term follow-up (2023) · cites this paper as [23]
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Multimodality imaging assessment of tetralogy of Fallot: From diagnosis to long-term follow-up
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Metadata
- Authors
- Vautier, M., Mulet, B., Macquaire, C., Cousergue, C., André, C.-O., Maragnes, P., Ollitrault, P., & Labombarda, F.
- Affiliations
- Centre Hospitalier Universitaire de Caen Normandie (FR)
- Normandie Université (FR)
- Corresponding author
- Labombarda, Fabien
- Venue
- Frontiers in Cardiovascular Medicine
- Publisher
- Frontiers Media SA
- Published
- 2023-04-26
- Volume
- 10
- Pages
- 1161017-1161017
- ISSN
- 2297-055X (ISSN-L)
- PMC
- PMC10169587
- OpenAlex
- W4367048715
- Cited by
- 6
- References
- 38
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 2
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Cardiovascular Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Keywords
- repaired tetralogy of Fallot, left atrial compliance, left atrial strain, malignant arrhythmias, left atrial function, right ventricular end-diastolic area, QRS duration, left ventricular ejection fraction, right ventricular function, arrhythmia prediction
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