In patients with repaired Tetralogy of Fallot, PQ interval correlated significantly with right ventricular end-diastolic volume (ρ = 0.52), and premature patients exhibited significantly shorter PQ intervals.
Cohort (n=219)
Single-blind
No
Do ECG changes correlate with right ventricular function, early age of repair, and prematurity in patients with Tetralogy of Fallot?
In patients with Tetralogy of Fallot, ECG changes such as PQ interval and RBBB correlate with right ventricular volume load, and prematurity is associated with shorter PQ intervals.
Estimación del efecto: ρ = 0.52
valor p: p=0.004
Tetralogy of Fallot (TOF) patients are at risk for long-term adverse events. Electrocardiogram (ECG) abnormalities may reflect ventricular maladaptation and predict complications. We investigated whether ECG changes correlated with cardiac magnetic resonance imaging (CMR) measures of right ventricular (RV) function and their prevalence in less mature myocardium (prematurity or early repair). This retrospective study included 219 TOF patients operated between 2000-01-01 and 2018-12-31. Parameters analyzed included PQ interval, QRS duration, dispersion, fragmentation, QTc, JTc, and right bundle branch block (RBBB) at predefined time points. In patients undergoing pulmonary valve replacement (PVR) with available CMR, measures of RV size and function were compared with ECG variables. Early repair was defined as < 3 months and prematurity < 37 weeks' gestation. Median age at follow-up was 12.3 years (IQR, 8.4;17), and 4.9 months (IQR, 3.4;6.9) at primary repair. PQ interval correlated with RV end-diastolic, stroke and regurgitant volume, whereas RBBB correlated with larger RV. Forty-five patients (21%) underwent early repair (median 2.3 months IQR 1.3;2.7) with no significant ECG differences. Forty-one patients (20%) were premature. Premature patients were older at repair versus term (5.8 months IQR 4.1;7.3 vs. 4.5 months IQR 3.0;6.3, p = 0.001) but weighed less (5.6 kg SD 1.2 vs. 6.5 kg SD 1.7, p = 0.001). PQ interval was shorter in premature patients at multiple time points. Neither prematurity nor early repair were associated with increased reintervention or PVR. These findings support an association between PQ interval and RV volume load. Shorter PQ intervals with prematurity may reflect stiff myocardium, with unknown long-term implications.
Bhat et al. (Thu,) conducted a cohort in Tetralogy of Fallot (n=219). Early repair (< 3 months) and Prematurity (< 37 weeks) vs. Non-early repair and Term birth was evaluated on Correlation between PQ interval and right ventricular end-diastolic volume (RVEDV) (ρ = 0.52, p=0.004). In patients with repaired Tetralogy of Fallot, PQ interval correlated significantly with right ventricular end-diastolic volume (ρ = 0.52), and premature patients exhibited significantly shorter PQ intervals.