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Background: We hypothesize that cardiac magnetic resonance (CMR) native T1 is associated with myocardial deformation in thalassaemia patients. The present study aimed to compare CMR native T1 values to conventional T2* values in patients with beta-thalassaemia and to explore relationships between these CMR parameters of myocardial iron overload and left ventricular (LV) and left atrial (LA) myocardial deformation. Methods: Thirty-four (16 males) patients aged 35.5 ± 9.2 years were studied. Myocardial T2* and T1 mapping were performed to assess the cardiac iron overload, while two-dimensional speckle-tracking echocardiography was performed in determine LV and LA myocardial deformation. Results: T2* was 36.4 ± 8.7 ms with 3 patients having myocardial iron load (T2*

Aims This study determined the associations between right atrial (RA) and right ventricular (RV) mechanics and liver stiffness in adults with repaired tetralogy of Fallot (TOF), pulmonary atresia with intact ventricular septum (PAVIS), and pulmonary stenosis (PS). Methods and results Ninety subjects including 26 repaired TOF, 24 PAIVS, and 20 PS patients and 20 controls were studied. Hepatic shear wave velocity and tissue elasticity (E), measures of liver stiffness, were assessed by two-dimensional shear wave elastography, while RA and RV mechanics were assessed by speckle tracking echocardiography. Deformation analyses revealed worse RV systolic strain and strain rate, and RA peak positive and total strain, and strain rates at ventricular systole and at early diastole in all of the patient groups compared with controls (all P  < 0.05). Compared with controls, all of the patient groups had significantly greater shear wave velocity and hepatic E -value (all P  < 0.05). Shear wave velocity and hepatic E -value correlated negatively with RV systolic strain rate, and RA positive strain, total strain, and strain rate at ventricular systole and at early diastole (all P  < 0.05). Multivariate analyses revealed RA strain rate at early diastole (P  = 0.015, P  < 0.001), maximum RA size (P  < 0.001, P  < 0.001), and severity of pulmonary regurgitation (P  = 0.05, P p = 0.014) as significant correlates of shear wave velocity and hepatic E -value. Conclusion In adults with repaired TOF, PAIVS, and PS, RA dysfunction and pulmonary regurgitation are associated with liver stiffness. [ABSTRACT FROM AUTHOR]

Introduction: Studies of cardiac mechanics in repaired tetralogy of Fallot (TOF) have focused on evaluation of ventricular mechanics and ventricular-ventricular interaction. Notwithstanding, the clinical relevance of atrial function is increasingly recognized. Importantly, assessment of atrial strain deformation has been rendered feasible with the use of tissue Doppler imaging (TDI), speckle tracking echocardiography (STE), and cardiac magnetic resonance feature tracking (CMR FT). We performed a systematic review of the current literature on assessment of right (RA) and left atrial (LA) deformation by myocardial strain imaging in patients with repaired TOF. Methods: This systematic review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) with search performed using the EMBASE and MEDLINE from their inception to March 2018. Of the total of 694 records initially identified, 10 studies with a total of 536 adolescent and adult repaired TOF patients were eventually included in the qualitative synthesis after screening for eligibility by 2 independent researchers. Results: Of the 10 studies, 5 evaluated RA deformation, 2 studied LA deformation, and 3 assessed deformation of both atria. Seven studies used 2D (n=5) or 3D (n=2) STE, 2 employed TDI, and one applied CMR FT for interrogation of atrial deformation. The main findings were 1) reduced regional and/or global RA and LA strain and strain rate consistent with reduced conduit, reservoir, and contractile function of the two atria in patients, 2) associations between RA and LA deformation indices suggestive of atrial-atrial interaction, and 3) relationships between RA deformation and indices of right ventricular systolic and diastolic function. Knowledge gaps identified include the lack of data on prognostic value of atrial strain for long-term outcomes and development of arrhythmic and other complications in repaired TOF patients. Conclusions: This systematic review demonstrates the usefulness of atrial strain imaging, in particular by STE, in the detection of impaired right and left atrial mechanics after TOF repair. [ABSTRACT FROM AUTHOR]