What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Repaired tetralogy of Fallot (n=126). Intervention: 4D flow cardiovascular magnetic resonance vs. Healthy controls. Primary outcome: Right ventricular direct flow (p=<0.001).

What does this research mean for the field?

In patients with repaired tetralogy of Fallot, right ventricular direct flow is significantly reduced compared to healthy controls and independently predicts right ventricular dysfunction, remodeling, and exercise intolerance. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2022Journal of Cardiovascular Magnetic ResonanceOpen Access

Ventricular flow analysis and its association with exertional capacity in repaired tetralogy of Fallot: 4D flow cardiovascular magnetic resonance study

Q: What are the key findings of this study?

In patients with repaired tetralogy of Fallot, median right ventricular direct flow was significantly lower compared to healthy controls (25% vs. 35%, P < 0.001) and independently predicted right ventricular dysfunction.

Q: What does this research mean for the field?

In patients with repaired tetralogy of Fallot, right ventricular direct flow is significantly reduced compared to healthy controls and independently predicts right ventricular dysfunction, remodeling, and exercise intolerance. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Repaired tetralogy of Fallot is associated with ~29% lower RV direct flow, predicting RV dysfunction.

P<0.001
n=126

Why the study?

It was unclear whether 4D flow CMR parameters can predict cardiopulmonary exercise testing outcomes in repaired tetralogy of Fallot.

Does 4D flow CMR-derived right ventricular direct flow correlate with RV dysfunction, remodelling, and exercise intolerance in patients with repaired tetralogy of Fallot?

Population

63 rTOF patients and 63 matched healthy controls

Comparison

rTOF patients vs age- and gender-matched healthy controls

Design

Prospective multicenter cross-sectional study

Authors

XZXiaodan ZhaoLiaoning Provincial People's Hospital LHLiwei HuKunming University of Science and Technology SLShuang LengHarbin Institute of Technology

Discussion

Member takes

Implication

RV direct flow by 4D flow CMR may flag early dysfunction in repaired tetralogy of Fallot; leaves open prospective validation before clinical adoption.

Study Design

Type

Cross-Sectional (n=126)

Multicenter

Yes

Structured PICO

Does 4D flow CMR-derived right ventricular direct flow correlate with RV dysfunction, remodelling, and exercise intolerance in patients with repaired tetralogy of Fallot?

Population

126 subjects total: 63 patients with repaired tetralogy of Fallot (rTOF) (14 paediatric, 49 adult; median age 29, 29 male) and 63 age- and gender-matched healthy controls with no prior cardiovascular disease, pulmonary disease, hypertension, or diabetes mellitus.

Intervention

Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) imaging with biventricular blood flow component and kinetic energy (KE) analyses, alongside cardiopulmonary exercise testing (CPET).

Comparator

Age- and gender-matched healthy controls undergoing the same CMR and CPET protocols.

Outcome

Comparison of 4D flow CMR parameters (direct flow, retained inflow, delayed ejection flow, residual volume, and KEiEDV) between rTOF and healthy controls, and their association with RV remodelling index (RVEDV/LVEDV ratio) and CPET outcomes.surrogate

Main Result

Absolute Event Rate: 25% vs 35%

p-value: p=<0.001

Limitations

Cross-sectional observational study design precludes the inference of causality in relationships.
Dataset was acquired using multi-vendor scanners at different field strengths and under different 4D flow CMR protocols.

Cite This Study

Zhao et al. (2022) conducted a cross-sectional in Repaired tetralogy of Fallot (n=126). 4D flow cardiovascular magnetic resonance vs. Healthy controls was evaluated on Right ventricular direct flow (p=<0.001). In patients with repaired tetralogy of Fallot, median right ventricular direct flow was significantly lower compared to healthy controls (25% vs. 35%, P < 0.001) and independently predicted right ventricular dysfunction.

synapsesocial.com/papers/6a19135e1d64db491ad31ef9 https://doi.org/10.1186/s12968-021-00832-2

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Implication

RV direct flow by 4D flow CMR may flag early dysfunction in repaired tetralogy of Fallot; leaves open prospective validation before clinical adoption.

Ventricular flow analysis and its association with exertional capacity in repaired tetralogy of Fallot: 4D flow cardiovascular magnetic resonance study

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Ventricular flow analysis and its association with exertional capacity in repaired tetralogy of Fallot: 4D flow cardiovascular magnetic resonance study

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

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