ArticleInternational journal of cardiology. Congenital heart disease2024
Right atrial reverse remodeling and risk of atrial arrhythmias after surgical pulmonary valve replacement.
Article in International journal of cardiology. Congenital heart disease, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Right Ventricular Function Assessed by Speckle Tracking Echocardiography in Patients Undergoing Transcatheter Pulmonary Valve Replacement.Pediatric cardiology · 2026Article
- Role of imaging techniques in monitoring atrial cardiomyopathy and atrial failure: a scientific statement.ESC heart failure · 2026Review
- Atrial and ventricular strain changes after transcatheter pulmonary valve replacement in patients with repaired tetralogy of Fallot: a feature tracking cardiac MRI study.Japanese journal of radiology · 2025Article
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Authors and funding
10 authors.
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Abstract
Background: Right atrial (RA) dysfunction and atrial arrhythmias are relatively common in adults with repaired tetralogy of Fallot. The purpose of this study was to determine whether RA function improved after surgical pulmonary valve replacement (PVR), and the association between postoperative RA reverse remodeling and late postoperative atrial arrhythmias. Method: RA reverse remodeling (ΔRA reservoir strain based speckle tracking echocardiography) was calculated as: ([postoperative RA reservoir strain - preoperative RA reservoir strain]/preoperative RA reservoir strain)x100. Optimal RA reverse remodeling was defined as ΔRA reservoir strain >15%. Results: Of 411 patients (age 36 ± 13 years), preoperative RA reservoir strain was 31 ± 13%, postoperative RA reserve remodeling was 13 ± 9%, and 171 (42%) had optimal RA reserve remodeling. Preoperative RA reservoir strain (β±SE 1.12 ± 0.09, p < 0.001) was associated with postoperative RA reverse remodeling on multivariable analysis. Preoperative RA reservoir strain ≥33% predicted optimal postoperative RA reverse remodeling (area under the curve 0.792).ΔRA reservoir strain was associated with postoperative atrial arrhythmias (HR 0.91, 95%CI 0.86-0.96, p = 0.004), on multivariable analysis. Compared to patients with preoperative RA reservoir strain <33% (n = 242, 59%), those with RA reservoir strain ≥33% (n = 169, 41%) had more robust RA reverse remodeling (ΔRA reverse remodeling 19 ± 11% versus 7 ± 10%, p < 0.001), and lower incidence of atrial arrhythmias (1.1% versus 2.9%, p = 0.003). Conclusions: Preoperative RA reservoir strain was associated with RA reverse remodeling after PVR, and in turn, postoperative atrial arrhythmia. These results suggest that RA strain indices could be used to determine optimal timing for PVR in order to reduce the risk of atrial arrhythmia.
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