Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
January 30, 2013European Heart Journal - Cardiovascular ImagingOpen Access

Restrictive right ventricular physiology after Tetralogy of Fallot repair is associated with fibrosis of the right ventricular outflow tract visualized on cardiac magnetic resonance imaging

View Full Paper
Ask AI
Bookmark
Share

Key result

Right ventricular outflow tract fibrosis on CMR was strongly associated with restrictive right ventricular physiology in children after Tetralogy of Fallot repair (OR 70.0; 95% CI 5.6-882.7; P<0.001).

Why the study?

Is right ventricular outflow tract fibrosis associated with restrictive right ventricular physiology in children after Tetralogy of Fallot repair?

Population

31 children evaluated 9.2 ± 2.9 years after total correction of Tetralogy of Fallot, and 12 healthy children.

Comparison

Presence of right ventricular outflow tract… vs Absence of RVOT fibrosis on LGE-CMR

Design

Cross-sectional

Follow-up

9.2 ± 2.9 years post-repair

Authors

PMP. MunkhammarLund UniversityMCMarcus CarlssonCardiac ImagingHAHåkan ArhedenCardiac Imaging

Discussion

Loading...

Member takes

Implication

Should not yet change post-TOF management; hypothesis-generating for RVOT fibrosis as driver of restrictive RV physiology.

Key Points

  • To investigate whether restrictive right ventricular physiology after surgical repair of Tetralogy of Fallot is associated with fibrosis in the right ventricular outflow tract.
  • Evaluated 31 pediatric patients (mean age 10.2 ± 2.8 years, 9.2 ± 2.9 years post-repair) and 12 healthy controls using cine, flow, and late gadolinium enhancement cardiac magnetic resonance imaging alongside Doppler echocardiography (4 patients excluded due to suboptimal imaging).
  • Defined restrictive right ventricular physiology as forward late diastolic flow across the pulmonary valve during atrial contraction exceeding the healthy control mean plus two standard deviations.
  • Restrictive physiology was present in 14 of 16 patients with right ventricular outflow tract fibrosis compared to 1 of 11 patients without fibrosis, corresponding to an odds ratio of 70.0 (95% CI: 5.6–882.7, P < 0.001).
  • The extent of outflow tract fibrosis correlated positively with pulmonary regurgitation (r² = 0.38, P < 0.001), right ventricular end-diastolic volume (r² = 0.51, P < 0.001), and end-systolic volume (r² = 0.47, P < 0.001).

Study Design

Type

Observational (n=31)

Structured PICO

Is right ventricular outflow tract fibrosis associated with restrictive right ventricular physiology in children after Tetralogy of Fallot repair?

P
Population
31 children (13 girls, mean age 10.2 ± 2.8 years) evaluated 9.2 ± 2.9 years after total correction of Tetralogy of Fallot (TOF), and 12 healthy children.
I
Intervention
Presence of right ventricular outflow tract (RVOT) fibrosis visualized on late gadolinium contrast enhanced cardiac magnetic resonance (LGE-CMR)
C
Comparator
Absence of RVOT fibrosis on LGE-CMR
O
Outcome
Restrictive RV physiology (defined as forward flow during atrial contraction above mean + 2 SD of healthy subjects)surrogate

Main Result

Effect estimate: OR 70.0 (95% CI 5.6-882.7)

Absolute Event Rate: 87.5% vs 9.1%

p-value: p=< 0.001

Restrictive right ventricular physiology in children after Tetralogy of Fallot repair is strongly associated with RVOT fibrosis detected by cardiac magnetic resonance imaging.

Cite This Study

Munkhammar et al. (2013) conducted an observational in Tetralogy of Fallot (n=31). Right ventricular outflow tract fibrosis vs. No right ventricular outflow tract fibrosis was evaluated on Restrictive right ventricular physiology (OR 70.0, 95% CI 5.6-882.7, p=< 0.001). Right ventricular outflow tract fibrosis on CMR was strongly associated with restrictive right ventricular physiology in children after Tetralogy of Fallot repair (OR 70.0; 95% CI 5.6-882.7; P<0.001).

synapsesocial.com/papers/6a0cfb4532f3c40b5ccbafbbhttps://doi.org/10.1093/ehjci/jet009

Topics

EchocardiographyCardiac MRI
View Full Paper
Ask AI
Bookmark
Share