What question did this study set out to answer?

To determine whether cardiovascular magnetic resonance (CMR) feature tracking measures of ventricular strain and dyssynchrony predict deterioration of ventricular function in patients with repaired tetralogy of Fallot (rTOF).

January 1, 2016Journal of Cardiovascular Magnetic ResonanceOpen Access

Left and right ventricular dyssynchrony and strains from cardiovascular magnetic resonance feature tracking do not predict deterioration of ventricular function in patients with repaired tetralogy of Fallot

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Why the study?

Do measures of ventricular strain and dyssynchrony from CMR predict deterioration of ventricular function in patients with repaired tetralogy of Fallot?

Key Points

To determine whether cardiovascular magnetic resonance (CMR) feature tracking measures of ventricular strain and dyssynchrony predict deterioration of ventricular function in patients with repaired tetralogy of Fallot (rTOF).
Retrospective cohort study evaluated 153 patients with rTOF (mean age 23 ± 14 years, 50% male) who underwent at least two CMR scans >6 months apart (mean follow-up 2.9 ± 1.3 years) at a single center without intervening procedures.
Custom feature tracking on baseline cine CMR measured seven strain and dyssynchrony parameters, which were modeled against longitudinal changes in RV end-diastolic volume and RV/LV ejection fraction using multivariate linear mixed models adjusting for 10 baseline confounders.
None of the seven primary baseline predictors—including left, right, or inter-ventricular dyssynchrony, and global circumferential or longitudinal strains—significantly correlated with longitudinal changes in ventricular volumes or ejection fractions after multivariable adjustment.
Baseline predictors and potential confounders together accounted for only 1% to 17% of the total variability in the rate of ventricular functional change over time.

Structured PICO

Do measures of ventricular strain and dyssynchrony from CMR predict deterioration of ventricular function in patients with repaired tetralogy of Fallot?

Population

153 patients with repaired tetralogy of Fallot (rTOF) who underwent cardiovascular magnetic resonance (CMR) at least twice, >6 months apart, without intervening surgical or catheter procedures. Mean age 23 ± 14 years, 50% male.

Intervention

Assessment of 7 primary predictors derived from the first CMR using a custom feature tracking algorithm: left (LV), right (RV) and inter-ventricular dyssynchrony, LV and RV peak global circumferential strains, and LV and RV peak global longitudinal strains.

Outcome

Changes over time in RV end-diastolic volume indexed to body surface area (RVEDVi), RV ejection fraction (RVEF), and LV ejection fraction (LVEF).surrogate

Ventricular dyssynchrony and global strain derived from cine CMR feature tracking do not significantly predict longitudinal changes in ventricular size and function in patients with repaired tetralogy of Fallot.

Discussion

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Implication

Ventricular strain and dyssynchrony may aid risk stratification in rTOF; this Level 4 analysis leaves open prospective validation before clinical adoption.

Cite This Study

Jing et al. (2016) studied this question.

synapsesocial.com/papers/6a728cb5febe604dd70aaa12 https://doi.org/10.1186/s12968-016-0268-8

Topics

Cardiac MRI

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Implication

Ventricular strain and dyssynchrony may aid risk stratification in rTOF; this Level 4 analysis leaves open prospective validation before clinical adoption.

Left and right ventricular dyssynchrony and strains from cardiovascular magnetic resonance feature tracking do not predict deterioration of ventricular function in patients with repaired tetralogy of Fallot

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Left and right ventricular dyssynchrony and strains from cardiovascular magnetic resonance feature tracking do not predict deterioration of ventricular function in patients with repaired tetralogy of Fallot

Key Points

Structured PICO

Discussion

Implication

Cite This Study

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Topics

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