CLINICAL STUDY
Right ventricular function in adults with repaired tetralogy of Fallot assessed with cardiovascular magnetic resonance imaging
detrimental role of right ventricular outflow aneurysms or akinesia and adverse right-to-left ventricular interaction
Periklis A. Davlouros, MD*,
Philip J. Kilner, MD, PhD ,
Tim S. Hornung, MD*,
Wei Li, MD, PhD*,
Jane M. Francis, DCR(R),
James C. C. Moon, MD,
Gillian C. Smith, BSe,
Tri Tat, PhD ,
Dudley J. Pennell, MD, FACC and
Michael A. Gatzoulis, MD, PhD, FACC*,*
* Department of Cardiology, Royal Brompton Hospital, London, United Kingdom
Cardiac Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom
Medical Statistics, Royal Brompton Hospital, London, United Kingdom
Manuscript received April 4, 2002;
revised manuscript received July 17, 2002,
accepted August 19, 2002.
* Reprint requests and correspondence: Dr. Michael A. Gatzoulis, Royal Bromptom Hospital, Sydney Street, London, SW3 6NP, United Kingdom.
m.gatzoulis{at}rbh.nthames.nhs.uk
OBJECTIVES: We examined the relationship among biventricular hemodynamics, pulmonary regurgitant fraction (PRF), right ventricular outflow tract (RVOT) aneurysm or akinesia, and baseline and surgical characteristics in adults with repaired tetralogy of Fallot (rTOF).
BACKGROUND: The precise relationship of pulmonary regurgitation with biventricular hemodynamics has been hampered by limitations of right ventricular (RV) imaging.
METHODS: We assessed 85 consecutive adults with rTOF and 26 matched healthy controls using cardiovascular magnetic resonance imaging.
RESULTS: Patients had higher right ventricular end-diastolic volume index (RVEDVi) (p < 0.001), right ventricular end-systolic volume index (RVESVi) (p < 0.001), right ventricular mass index (RVMi) (p < 0.001), and lower right ventricular ejection fraction (RVEF) (p < 0.001) and left ventricular ejection fraction (LVEF) (p = 0.002) compared to controls. The PRF (range 0% to 55%) independently predicted RVEDVi (p < 0.01) and the latter predicted RVESVi (p < 0.01) and RVMi (p < 0.01). The RVOT aneurysm/akinesia was present in 48/85 (56.9%) of patients and predicted RV volumes (RVEDVi, p = 0.01, and RVESVi, p = 0.03). There was a negative effect of RVOT aneurysm/akinesia and RVMi on RVEF (p < 0.01 and p = 0.02, respectively). There was only a tendency among patients with transannular or RVOT patching toward RVOT aneurysm/akinesia (p = 0.09). The LVEF correlated with RVEF (r = 0.67, p < 0.001).
CONCLUSIONS: Pulmonary regurgitation and RVOT aneurysm/akinesia were independently associated with RV dilation and the latter with RV hypertrophy late after rTOF. The RVOT aneurysm/akinesia was common but related only in part to RVOT or transannular patching. Both RV hypertrophy and RVOT aneurysm/akinesia were associated with lower RVEF. Left ventricular systolic dysfunction correlated with RV dysfunction, suggesting an unfavorable ventricular-ventricular interaction. Measures to maintain or restore pulmonary valve function and avoid RVOT aneurysm/akinesia are mandatory for preserving biventricular function late after rTOF.
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Abbreviations and Acronyms
| | CMR | | cardiovascular magnetic resonance | | LV | | left ventricle/ventricular | | LVEDVi | | left ventricular end-diastolic volume index (ml/m2) | | LVEF | | left ventricular ejection fraction (%) | | LVESVi | | left ventricular end-systolic volume index (ml/m2) | | LVMi | | total left ventricular mass index (g/m2) | | PR | | pulmonary regurgitation | | PRF | | pulmonary regurgitant fraction (%) | | PVR | | pulmonary valve replacement | | rTOF | | repair of tetralogy of Fallot | | RV | | right ventricle/ventricular | | RVEDVi | | right ventricular end-diastolic volume index (ml/m2) | | RVEF | | right ventricular ejection fraction (%) | | RVESVi | | right ventricular end-systolic volume index (ml/m2) | | RVMi | | right ventricular mass index (g/m2) | | RVOT | | right ventricular outflow tract |
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|
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119(10):
1370 - 1377.
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[PDF]
|
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|
|
|
|
|
C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al.
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J. Am. Coll. Cardiol.,
December 2, 2008;
52(23):
e143 - e263.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al.
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52(23):
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|
|
|
|
|
|
|
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December 2, 2008;
118(23):
e714 - e833.
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[PDF]
|
|
|
|
|
|
|
C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al.
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Circulation,
December 2, 2008;
118(23):
2395 - 2451.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. V Huehnergarth, M. Gurvitz, K. K Stout, and C. M Otto
Repaired tetralogy of Fallot in the adult: monitoring and management
Heart,
December 1, 2008;
94(12):
1663 - 1669.
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. Voges, G. Fischer, J. Scheewe, M. Schumacher, S. V. Babu-Narayan, O. Jung, H.-H. Kramer, and A. Uebing
Restrictive enlargement of the pulmonary annulus at surgical repair of tetralogy of Fallot: 10-year experience with a uniform surgical strategy
Eur. J. Cardiothorac. Surg.,
November 1, 2008;
34(5):
1041 - 1045.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. J. Silka and Y. Bar-Cohen
Should patients with congenital heart disease and a systemic ventricular ejection fraction less than 30% undergo prophylactic implantation of an ICD?: Patients With Congenital Heart Disease and a Systemic Ventricular Ejection Fraction Less Than 30% Should Undergo Prophylactic Implantation of an Implantable Cardioverter Defibrillator
Circ Arrhythm Electrophysiol,
October 1, 2008;
1(4):
298 - 306.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Frigiola, V. Tsang, J. Nordmeyer, P. Lurz, C. van Doorn, A. M. Taylor, P. Bonhoeffer, and M. de Leval
Current approaches to pulmonary regurgitation
Eur. J. Cardiothorac. Surg.,
September 1, 2008;
34(3):
576 - 581.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. K. Bodhey, P. Beerbaum, S. Sarikouch, S. Kropf, P. Lange, F. Berger, R. H. Anderson, and T. Kuehne
Functional Analysis of the Components of the Right Ventricle in the Setting of Tetralogy of Fallot
Circ Cardiovasc Imaging,
September 1, 2008;
1(2):
141 - 147.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Bordachar, X. Iriart, J. Chabaneix, F. Sacher, S. Lafitte, P. Jais, M. Haissaguerre, J. Clementy, P. Dos Santos, and J.-B. Thambo
Presence of ventricular dyssynchrony and haemodynamic impact of right ventricular pacing in adults with repaired Tetralogy of Fallot and right bundle branch block
Europace,
August 1, 2008;
10(8):
967 - 971.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Uebing, S. V. Babu-Narayan, G. P. Diller, K. Dimopoulos, O. Goktekin, M. S. Spence, K. Andersen, M. A. Gatzoulis, W. Li, D. G. Gibson, et al.
Response to Letter Regarding Article, "Right Ventricular Mechanics and QRS Duration in Patients With Repaired Tetralogy of Fallot: Implications of Infundibular Disease"
Circulation,
April 1, 2008;
117(13):
e301 - e301.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A L Knauth, K Gauvreau, A J Powell, M J Landzberg, E P Walsh, J E Lock, P J d. Nido, and T Geva
Ventricular size and function assessed by cardiac MRI predict major adverse clinical outcomes late after tetralogy of Fallot repair
Heart,
February 1, 2008;
94(2):
211 - 216.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. J. Meijboom, J. W. Roos-Hesselink, J. S. McGhie, S. E.C. Spitaels, R. T. van Domburg, L. M.W.J. Utens, M. L. Simoons, and A. J.J.C. Bogers
Consequences of a selective approach toward pulmonary valve replacement in adult patients with tetralogy of Fallot and pulmonary regurgitation
J. Thorac. Cardiovasc. Surg.,
January 1, 2008;
135(1):
50 - 55.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. L Gentles
Watching the right ventricle in treated congenital heart disease
Heart,
December 1, 2007;
93(12):
1502 - 1503.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Soler, E. Rodriguez, M. Alvarez, and I. Raposo
Postoperative Imaging in Cyanotic Congenital Heart Diseases: Part 2, Complications
Am. J. Roentgenol.,
December 1, 2007;
189(6):
1361 - 1369.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Zeppenfeld, M. J. Schalij, M. M. Bartelings, U. B. Tedrow, B. A. Koplan, K. Soejima, and W. G. Stevenson
Catheter Ablation of Ventricular Tachycardia After Repair of Congenital Heart Disease: Electroanatomic Identification of the Critical Right Ventricular Isthmus
Circulation,
November 13, 2007;
116(20):
2241 - 2252.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Uebing, D. G. Gibson, S. V. Babu-Narayan, G. P. Diller, K. Dimopoulos, O. Goktekin, M. S. Spence, K. Andersen, M. Y. Henein, M. A. Gatzoulis, et al.
Right Ventricular Mechanics and QRS Duration in Patients With Repaired Tetralogy of Fallot: Implications of Infundibular Disease
Circulation,
October 2, 2007;
116(14):
1532 - 1539.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. S. Broberg, M. Ujita, S. Prasad, W. Li, M. Rubens, B. E. Bax, S. J. Davidson, B. Bouzas, J. S. R. Gibbs, J. Burman, et al.
Pulmonary Arterial Thrombosis in Eisenmenger Syndrome Is Associated With Biventricular Dysfunction and Decreased Pulmonary Flow Velocity
J. Am. Coll. Cardiol.,
August 14, 2007;
50(7):
634 - 642.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Mertens
Deciphering the mystery of the leaky pulmonary valve in a new era of interventional cardiology
Eur. Heart J.,
August 1, 2007;
28(15):
1793 - 1794.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. R Chaturvedi and A. N Redington
Pulmonary regurgitation in congenital heart disease
Heart,
July 1, 2007;
93(7):
880 - 889.
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. Ghez, V. T. Tsang, A. Frigiola, L. Coats, A. Taylor, C. Van Doorn, P. Bonhoeffer, and M. De Leval
Right ventricular outflow tract reconstruction for pulmonary regurgitation after repair of tetralogy of Fallot.: Preliminary results
Eur. J. Cardiothorac. Surg.,
April 1, 2007;
31(4):
654 - 658.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. van den Berg, W. C. Hop, J. L.M. Strengers, J. C. de Jongste, L. van Osch-Gevers, F. J. Meijboom, P. M.T. Pattynama, A. J.J.C. Bogers, and W. A. Helbing
Clinical condition at mid-to-late follow-up after transatrial-transpulmonary repair of tetralogy of Fallot
J. Thorac. Cardiovasc. Surg.,
February 1, 2007;
133(2):
470 - 477.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-J. Ge, X.-G. Shi, R.-Y. Zhou, M. Lin, S.-L. Ge, and S.-B. Zhang
Right Ventricular Dysfunction Due to Right Ventricular Outflow Tract Patch
Asian Cardiovasc Thorac Ann,
June 1, 2006;
14(3):
213 - 218.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. K. Chowdhury, K. K. Pradeep, C. D. Patel, R. Singh, A. S. Kumar, B. Airan, G. S. Gulati, S. S. Kothari, A. Saxena, M. Kalaivani, et al.
Noninvasive Assessment of Repaired Tetralogy of Fallot by Magnetic Resonance Imaging and Dynamic Radionuclide Studies
Ann. Thorac. Surg.,
April 1, 2006;
81(4):
1436 - 1442.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. M. Chauvaud, A. C. Hernigou, E. R. Mousseaux, D. Sidi, and J.-L. Hebert
Ventricular Volumes in Ebstein's Anomaly: X-Ray Multislice Computed Tomography Before and After Repair
Ann. Thorac. Surg.,
April 1, 2006;
81(4):
1443 - 1449.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Frigiola, A. Giamberti, M. Chessa, M. Di Donato, R. Abella, S. Foresti, C. Carlucci, D. Negura, M. Carminati, G. Buckberg, et al.
Right ventricular restoration during pulmonary valve implantation in adults with congenital heart disease
Eur. J. Cardiothorac. Surg.,
April 1, 2006;
29(Suppl_1):
S279 - S285.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P A Davlouros, K Niwa, G Webb, and M A Gatzoulis
The right ventricle in congenital heart disease
Heart,
April 1, 2006;
92(suppl_1):
i27 - i38.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. G. Williams, G. D. Pearson, R. J. Barst, J. S. Child, P. del Nido, W. M. Gersony, K. S. Kuehl, M. J. Landzberg, M. Myerson, S. R. Neish, et al.
Report of the National Heart, Lung, and Blood Institute Working Group on Research in Adult Congenital Heart Disease
J. Am. Coll. Cardiol.,
February 21, 2006;
47(4):
701 - 707.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. V. Babu-Narayan, P. J. Kilner, W. Li, J. C. Moon, O. Goktekin, P. A. Davlouros, M. Khan, S. Y. Ho, D. J. Pennell, and M. A. Gatzoulis
Ventricular Fibrosis Suggested by Cardiovascular Magnetic Resonance in Adults With Repaired Tetralogy of Fallot and Its Relationship to Adverse Markers of Clinical Outcome
Circulation,
January 24, 2006;
113(3):
405 - 413.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. I. Norton, C. Tong, R. B. J. Glass, and J. C. Nielsen
Cardiac MR Imaging Assessment Following Tetralogy of Fallot Repair
RadioGraphics,
January 1, 2006;
26(1):
197 - 211.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. R. V. Buechel, H. H. Dave, C. J. Kellenberger, A. Dodge-Khatami, R. Pretre, F. Berger, and U. Bauersfeld
Remodelling of the right ventricle after early pulmonary valve replacement in children with repaired tetralogy of Fallot: assessment by cardiovascular magnetic resonance
Eur. Heart J.,
December 2, 2005;
26(24):
2721 - 2727.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Oosterhof, B. J. M. Mulder, H. W. Vliegen, and A. de Roos
Corrected Tetralogy of Fallot: Delayed Enhancement in Right Ventricular Outflow Tract
Radiology,
December 1, 2005;
237(3):
868 - 871.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Khambadkone, L. Coats, A. Taylor, Y. Boudjemline, G. Derrick, V. Tsang, J. Cooper, V. Muthurangu, S. R. Hegde, R. S. Razavi, et al.
Percutaneous Pulmonary Valve Implantation in Humans: Results in 59 Consecutive Patients
Circulation,
August 23, 2005;
112(8):
1189 - 1197.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.F. M. Bechtel, P. E. Lange, and H. H. Sievers
Optimal Size of a Monocusp Patch for Reconstruction of a Hypoplastic Pulmonary Root: An Experimental Study in Pigs
Ann. Thorac. Surg.,
June 1, 2005;
79(6):
2103 - 2108.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Yin, J. Salazar, L. Nolke, A. Azakie, and T. R Karl
Late Pulmonary Valve Implantation after Repair of Tetralogy of Fallot
Asian Cardiovasc Thorac Ann,
June 1, 2005;
13(2):
139 - 142.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. H. van Huysduynen, A. van Straten, C. A. Swenne, A. C. Maan, H. J. Ritsema van Eck, M. J. Schalij, E. E. van der Wall, A. de Roos, M. G. Hazekamp, and H. W. Vliegen
Reduction of QRS duration after pulmonary valve replacement in adult Fallot patients is related to reduction of right ventricular volume
Eur. Heart J.,
May 1, 2005;
26(9):
928 - 932.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Bouzas, P. J. Kilner, and M. A. Gatzoulis
Pulmonary regurgitation: not a benign lesion
Eur. Heart J.,
March 1, 2005;
26(5):
433 - 439.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Oosterhof, J.W.J. Vriend, B.J.M. Mulder, A. Frigiola, S. Cullen, A. Redington, and M. Vogel
Letter Regarding Article by Frigiola et al, "Pulmonary Regurgitation Is an Important Determinant of Right Ventricular Contractile Dysfunction in Patients With Surgically Repaired Tetralogy of Fallot" * Response
Circulation,
March 1, 2005;
111(8):
e112 - e112.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. van Straten, H. W. Vliegen, M. G. Hazekamp, J. J. Bax, P. H. Schoof, J. Ottenkamp, E. E. van der Wall, and A. de Roos
Right Ventricular Function after Pulmonary Valve Replacement in Patients with Tetralogy of Fallot
Radiology,
December 1, 2004;
233(3):
824 - 829.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Frigiola, A.N. Redington, S. Cullen, and M. Vogel
Pulmonary Regurgitation Is an Important Determinant of Right Ventricular Contractile Dysfunction in Patients With Surgically Repaired Tetralogy of Fallot
Circulation,
September 14, 2004;
110(11_suppl_1):
II-153 - II-157.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P Georgiadou, S V Babu-Narayan, D P Francis, D T Kremastinos, and M A Gatzoulis
Periodic breathing as a feature of right heart failure in congenital heart disease
Heart,
September 1, 2004;
90(9):
1075 - 1076.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Geva, B. M. Sandweiss, K. Gauvreau, J. E. Lock, and A. J. Powell
Factors associated with impaired clinical status in long-term survivors of tetralogy of Fallot repair evaluated by magnetic resonance imaging
J. Am. Coll. Cardiol.,
March 17, 2004;
43(6):
1068 - 1074.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. A. Atik, E. Atik, C. R. da Cunha, L. F. Caneo, R. S. Assad, M. B. Jatene, A. Riso, and M. Barbero-Marcial
Long-term results of correction of tetralogy of Fallot in adulthood
Eur. J. Cardiothorac. Surg.,
February 1, 2004;
25(2):
250 - 255.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. d'Udekem d'Acoz, A. Pasquet, L. Lebreux, C. Ovaert, F. Mascart, A. Robert, and J. E. Rubay
Does right ventricular outflow tract damage play a role in the genesis of late right ventricular dilatation after tetralogy of Fallot repair?
Ann. Thorac. Surg.,
August 1, 2003;
76(2):
555 - 561.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
