Differences in right ventricular-pulmonary vascular coupling and clinical indices between repaired standard tetralogy of Fallot and repaired tetralogy of Fallot with pulmonary atresia期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

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Differences in right ventricular-pulmonary vascular coupling and clinical indices between repaired standard tetralogy of Fallot and repaired tetralogy of Fallot with pulmonary atresia

Authors:	S Buddhe V Jani S Sarikouch L Gaur A Schuster P Beerbaum M Lewin S Kutty

Institution:	1. Division of Pediatric Cardiology, Department of Pediatrics, Seattle Children''s Hospital, 91805 Seattle, WA, USA;2. Blalock Taussig Thomas Heart Center, The Johns Hopkins Hospital and School of Medicine, 1800 Orleans St, 21287 Baltimore, MD, USA;3. Department of Heart- Thoracic- Transplantation- and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany;4. Department of Cardiology and Pneumology, University of Goettingen School of Medicine, 37075 Göttingen, Germany;5. Department of Pediatric Cardiology and Pediatric Intensive Care, Hannover Medical School, Hannover Medical School, Hannover, Germany

Abstract:	PurposeThe 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 methodsPatients 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.ResultsA 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).ConclusionNon-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.

Keywords:	Tetralogy of Fallot Magnetic resonance imaging Pulmonary atresia Pulmonary artery Right ventricular dysfunction CMR"} {"#name":"keyword" "$":{"id":"kw0035"} "$$":[{"#name":"text" "_":"Cardiac magnetic resonance CPET"} {"#name":"keyword" "$":{"id":"kw0045"} "$$":[{"#name":"text" "_":"Cardiopulmonary exercise test Ea"} {"#name":"keyword" "$":{"id":"kw0055"} "$$":[{"#name":"text" "_":"Arterial elastance EDVi"} {"#name":"keyword" "$":{"id":"kw0065"} "$$":[{"#name":"text" "_":"Indexed end-diastolic volume Ees"} {"#name":"keyword" "$":{"id":"kw0075"} "$$":[{"#name":"text" "_":"Ventricular elastance EF"} {"#name":"keyword" "$":{"id":"kw0085"} "$$":[{"#name":"text" "_":"Ejection fraction ESVi"} {"#name":"keyword" "$":{"id":"kw0095"} "$$":[{"#name":"text" "_":"Indexed end-systolic volume IQR"} {"#name":"keyword" "$":{"id":"kw0105"} "$$":[{"#name":"text" "_":"Interquartile range LV"} {"#name":"keyword" "$":{"id":"kw0115"} "$$":[{"#name":"text" "_":"Left Ventricle MAPCA"} {"#name":"keyword" "$":{"id":"kw0125"} "$$":[{"#name":"text" "_":"Major aortopulmonary collateral arteries NYHA"} {"#name":"keyword" "$":{"id":"kw0135"} "$$":[{"#name":"text" "_":"New York Heart Association PA"} {"#name":"keyword" "$":{"id":"kw0145"} "$$":[{"#name":"text" "_":"Pulmonary atesia PI"} {"#name":"keyword" "$":{"id":"kw0155"} "$$":[{"#name":"text" "_":"Pulmonary insufficiency QRS"} {"#name":"keyword" "$":{"id":"kw0165"} "$$":[{"#name":"text" "_":"QRS duration on 12 lead electrocardiogram rTOF"} {"#name":"keyword" "$":{"id":"kw0175"} "$$":[{"#name":"text" "_":"repaired tetralogy of Fallot RV"} {"#name":"keyword" "$":{"id":"kw0185"} "$$":[{"#name":"text" "_":"Right ventricle SV"} {"#name":"keyword" "$":{"id":"kw0195"} "$$":[{"#name":"text" "_":"Stroke volume TOF"} {"#name":"keyword" "$":{"id":"kw0205"} "$$":[{"#name":"text" "_":"Tetralogy of Fallot VVCR"} {"#name":"keyword" "$":{"id":"kw0215"} "$$":[{"#name":"text" "_":"Ventricular vascular coupling ratio
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