Key result
Right ventricular extracellular volume (RVECV) was associated with increased risk of adverse cardiovascular events in adults with repaired tetralogy of Fallot (HR 1.13; 95% CI 1.01-1.28; P=0.037).
Why the study?
Does increased right ventricular extracellular volume (RVECV) measured by cardiovascular magnetic resonance predict adverse cardiovascular outcomes in adults with repaired tetralogy of Fallot?
Cohort (n=54)
Does increased right ventricular extracellular volume (RVECV) measured by cardiovascular magnetic resonance predict adverse cardiovascular outcomes in adults with repaired tetralogy of Fallot?
Effect estimate: HR 1.13 (95% CI 1.01-1.28)
p-value: p=0.037
Increased right ventricular extracellular volume measured by cardiovascular magnetic resonance is associated with a higher risk of adverse cardiovascular events in adults with repaired tetralogy of Fallot.
RVECV may aid risk stratification in repaired tetralogy of Fallot; hypothesis-generating and requires prospective validation.
Aims: Our aims were to explore cardiac magnetic resonance quantification of myocardial extracellular volume (ECV) in adults with repaired tetralogy of Fallot (rTOF) when compared with healthy controls and to investigate the association between ECV and major adverse cardiovascular outcomes. Methods and results: We prospectively recruited adults with rTOF (n = 44, 59% male, 32.9 ± 13.6 years) and evaluated right ventricular (RV) and left ventricular (LV) ECV by pre/post-gadolinium T1 measurements (modified Look-Locker inversion recovery technique) on a 1.5-T Siemens scanner compared with the healthy controls (n = 10, 50% male, 31.5 ± 4.4 years). The primary end point was a composite of death, out-of-hospital cardiac arrest, heart failure (HF) requiring admission for escalation of therapy, or haemodynamically significant ventricular tachycardia (VT) (lasting >30 s and/or resulting in invasive therapy). The association between ECV and adverse events was assessed using Cox proportional hazard models [median follow-up 236 days, interquartile range (IQR) 38-342]. RVECV was higher in patients compared with the controls (31.5 ± 5.4% vs. 26.3 ± 2.1%, P = 0.027). The following major adverse events occurred (n = 9, 21%): death (n = 1), out-of-hospital cardiac arrest (n = 1), HF (n = 1), and VT (n = 6). RVECV was higher among those with an adverse event compared to those without (35.0 ± 5.5% vs. 29.6 ± 4.5%, P = 0.014) and was associated with increased risk for adverse events [hazard ratio 1.13, 95% confidence interval (1.01-1.28); P = 0.037]. LVECV was not associated with adverse events (P = 0.667). Conclusion: Increased RVECV is associated with adverse cardiovascular events in adults with rTOF. These results may lead to further studies exploring the potential role for RVECV in risk stratification and targeted therapeutic interventions in this population.
No takes yet. Share an insight, caveat, or question.
Hanneman et al. (2017) conducted a cohort in Repaired tetralogy of Fallot (rTOF) (n=54). Right ventricular extracellular volume (RVECV) measurement vs. Healthy controls was evaluated on Composite of death, out-of-hospital cardiac arrest, heart failure requiring admission for escalation of therapy, or haemodynamically significant ventricular tachycardia (HR 1.13, 95% CI 1.01-1.28, p=0.037). Right ventricular extracellular volume (RVECV) was associated with increased risk of adverse cardiovascular events in adults with repaired tetralogy of Fallot (HR 1.13; 95% CI 1.01-1.28; P=0.037).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: