Management of congenital heart disease (CHD) in adults (ACHD) remains an ongoing challenge due to the presence of residual hemodynamic lesions and development of ventricular dysfunction in a large number of patients. Echocardiographic imaging plays a central role in clinical decision-making and selection of patients who will benefit most from catheter interventions or cardiac surgery.. Recent advances in both strain imaging and three-dimensional (3D)-echocardiography have significantly contributed to a greater understanding of the complex pathophysiological mechanisms involved in CHD. The aim of this paper is to provide an overview of emerging clinical applications of speckle-tracking imaging and 3D-echocardiography in ACHD with focus on functional assessment, ventriculo-ventricular interdependency, mechanisms of electromechanical delay, and twist abnormalities in adults with tetralogy of Fallot (TOF), a systemic RV after atrial switch repair or in double discordance ventricles, and in those with a Fontan circulation.

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Keywords Adult congenital heart disease (AHCD), echocardiography, speckle tracking, strain, three-dimensional echocardiography (3D echocardiography), dyssynchrony, heart failure
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Journal Cardiovascular Diagnosis and Therapy
Huntgeburth, M., Germund, I, Geerdink, L.M, Sreeram, N, & ten Cate, F.J. (2018). Emerging clinical applications of strain imaging and three-dimensional echocardiography for the assessment of ventricular function in adult congenital heart disease. Cardiovascular Diagnosis and Therapy, 9, S326–S345. doi:10.21037/cdt.2018.11.08