Key result
Patients with repaired tetralogy of Fallot show ~11% higher RV native T1, indicating persistent myocardial fibrosis.
Why the study?
CMR assessment of myocardial fibrosis is not routinely performed in rTOF due to technical challenges measuring RV native T1 and ECV, and native T1's role remains unclear.
Can cardiac magnetic resonance with native T1 and ECV assessment evaluate interstitial fibrosis in patients with repaired tetralogy of Fallot?
Meta-Analysis (n=1,177)
Can cardiac magnetic resonance with native T1 and ECV assessment evaluate interstitial fibrosis in patients with repaired tetralogy of Fallot?
Patients with repaired tetralogy of Fallot frequently exhibit evidence of myocardial fibrosis assessed by CMR native T1 and ECV, indicating adverse remodeling.
Supports CMR native T1 for fibrosis detection in repaired tetralogy of Fallot; leaves open its prognostic role pending outcome studies.
Background: The assessment of myocardial fibrosis by cardiac magnetic resonance (CMR) in patients with repaired tetralogy of Fallot (rTOF) is not routinely performed, primarily due to technical challenges in measuring right ventricular native T1 and extracellular volume (ECV). Additionally, although native T1 can be assessed without contrast, offering broader applicability, its role in evaluating myocardial fibrosis in rTOF patients remains unclear. Objectives: The aim of this systematic review and meta-analysis was to evaluate interstitial fibrosis in both the right and left ventricles using native T1 and ECV quantification in patients with rTOF. Methods: This systematic review was conducted according to the 2020 PRISMA guidelines and was registered in PROSPERO. The PubMed, Scopus, and Embase databases were searched to identify studies in which patients with rTOF underwent CMR with native T1 and ECV assessment. Random-effect models were used to estimate pooled effect sizes. Conclusion: Despite successful surgical repair, patients with rTOF frequently exhibit evidence of myocardial fibrosis, a marker of adverse remodeling that may progress long after anatomical correction.
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Secco et al. (2025) conducted a meta-analysis in Repaired tetralogy of Fallot (n=1,177). Cardiac magnetic resonance (CMR) with T1 mapping vs. Healthy controls was evaluated on Right ventricular native T1 (ms) (d = 1.36, p=<0.01). Patients with repaired tetralogy of Fallot had significantly higher right ventricular native T1 values compared to healthy controls (1090 vs 981 ms, d=1.36), indicating persistent myocardial fibrosis.
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