Extract

Background: Fontan palliation has contributed to a growing adult population with univentricular hearts (UVH). However, patients with UVH often suffer from progressive heart failure and arrhythmias leading to transplantation or death. Some previous studies on children have suggested the presence of dyssynchrony in different UVH morphologies.

Purpose: Since cardiac resynchronization therapy (CRT) might be an effective treatment in carefully selected patients, we investigated the presence of classic-pattern dyssynchrony (CPD) and its relation to increased QRS duration and association with systolic and diastolic dysfunction.

Methods: In a retrospective cross-sectional study, we investigated 101 adult patients with Fontan circulation. By post-processing a short axis and long-axis 2D images we generated strain curves that were visually assessed for the presence of early and late activated deformation, if the typical activation pattern was present patients were assigned to CPD group. Peak systolic strain, diastolic strain-rate (SR), and mean tissue velocities were automatically extracted from the strain- and displacement curves. Cardiac ultrasound images of 99 age- and gender matched control subjects were analyzed in the same way.

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