Differences in right ventricular-pulmonary vascular coupling and clinical indices between repaired standard tetralogy of Fallot and repaired tetralogy of Fallot with pulmonary atresia - 23/01/21
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Highlights |
• | There is a relationship between ventricular vascular coupling ratio and traditional cardiovascular magnetic resonance imaging parameters. |
• | Ventricular vascular coupling ratio is greater in patients with repaired tetralogy of Fallot and pulmonary compared to those with repaired standard tetralogy of Fallot. |
• | Ventricular vascular coupling ratio is of potential clinical value as an indicator of right heart performance in tetralogy of Fallot. |
Abstract |
Purpose |
The purpose of this study was to compare ventricular vascular coupling ratio (VVCR) between patients with repaired standard tetralogy of Fallot (TOF) and those with repaired TOF-pulmonary atresia (TOF-PA) using cardiovascular magnetic resonance (CMR).
Materials and methods |
Patients with repaired TOF aged>6 years were prospectively enrolled for same day CMR, echocardiography, and exercise stress test following a standardized protocol. Sanz's method was used to calculate VVCR as right ventricle (RV) end-systolic volume/pulmonary artery stroke volume. Regression analysis was used to examine associations with exercise test parameters, New York Heart Association (NYHA) class, RV size and biventricular systolic function.
Results |
A total of 248 subjects were included; of these 222 had repaired TOF (group I, 129 males; mean age, 15.9±4.7 [SD] years [range: 8–29 years]) and 26 had repaired TOF-PA (group II, 14 males; mean age, 17.0±6.3 [SD] years [range: 8–29 years]). Mean VVCR for all subjects was 1.54±0.64 [SD] (range: 0.43–3.80). Mean VVCR was significantly greater in the TOF-PA group (1.81±0.75 [SD]; range: 0.78–3.20) than in the standard TOF group (1.51±0.72 [SD]; range: 0.43–3.80) (P=0.03). VVCR was greater in the 68 NYHA class II subjects (1.79±0.66 [SD]; range: 0.75–3.26) compared to the 179 NYHA class I subjects (1.46±0.61 [SD]; range: 0.43–3.80) (P<0.001).
Conclusion |
Non-invasive determination of VVCR using CMR is feasible in children and adolescents. VVCR showed association with NYHA class, and was worse in subjects with repaired TOF-PA compared to those with repaired standard TOF. VVCR shows promise as an indicator of pulmonary artery compliance and cardiovascular performance in this cohort.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Tetralogy of Fallot, Magnetic resonance imaging, Pulmonary atresia, Pulmonary artery, Right ventricular dysfunction
Abbreviations : CMR, CPET, Ea, EDVi, Ees, EF, ESVi, IQR, LV, MAPCA, NYHA, PA, PI, QRS, rTOF, RV, SV, TOF, VVCR
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Vol 102 - N° 2
P. 85-91 - febbraio 2021 Ritorno al numero
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