부산대학교 도서관

BACKGROUND: Congenital heart defects such as coarctation or valvular aortic stenosis are followed by changes in left ventricular myocardial deformation mechanics induced by pressure overload. METHODS: Echocardiography was performed in 37 patients (aged 0-27 years, 15 female) with coarctation (27) or valvular aortic stenosis (10) before and after interventional catheterization and compared with 37 body surface area/age-matched healthy children. Deformation was calculated by 2-dimensional strain speckle tracking. RESULTS: Stress gradients under provocation with orciprenaline in coarctation decreased from 51.8 ± 20.0 mm Hg to 6.0 ± 12.0 mm Hg (P < .0001), and resting gradients in aortic stenoses decreased from 57.5 ± 18.8 mm Hg to 25.5 ± 14.0 mm Hg (P < .0001) after intervention. Patients had an increased maximal torsion (tormax: 16.7 ± 6.7 deg vs 11.0 ± 4.7 deg (controls; P < .0001), which decreased significantly after therapy (11.8 ± 4.9 deg, P < .0001). CONCLUSION: Compensatory elevation of left ventricular tormax in children with moderate left ventricular pressure load changes rapidly after successful interventional treatment. tormax may be a valuable tool to assess cardiac unloading or indicate the need for interventional treatment.