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August 1, 2021Circulation Cardiovascular ImagingOpen Access

Impaired Exercise Tolerance in Repaired Tetralogy of Fallot Is Associated With Impaired Biventricular Contractile Reserve: An Exercise-Stress Real-Time Cardiovascular Magnetic Resonance Study

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Why the study?

Does real-time cardiovascular magnetic resonance exercise testing reveal the mechanisms of impaired exercise capacity in patients with corrected tetralogy of Fallot compared to healthy controls?

Population

33 patients with corrected tetralogy of Fallot (cTOF) and 35 matched healthy controls

Comparison

Cardiopulmonary exercise testing and real-time… vs Matched healthy controls undergoing the same…

Design

Case-control

Key result

Patients with repaired tetralogy of Fallot exhibited significantly lower exercise capacity, reduced pulmonary blood flow, and impaired biventricular function compared to healthy controls.

Authors

MSMichael SteinmetzTSThomas StümpfigMSMatthias Seehase

Discussion

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Overview

LV contractile reserve during exercise may contribute to cTOF intolerance; extends RV-centric models but remains hypothesis-generating for PVR stratification.

Study Design

Type

Case-Control (n=68)

Structured PICO

Does real-time cardiovascular magnetic resonance exercise testing reveal the mechanisms of impaired exercise capacity in patients with corrected tetralogy of Fallot compared to healthy controls?

P
Population
68 participants, including 33 patients with repaired tetralogy of Fallot and 35 matched healthy controls, evaluated with cardiopulmonary and cardiovascular magnetic resonance exercise testing.
E
Exposure
Cardiopulmonary exercise testing (CPET) and real-time cardiovascular magnetic resonance exercise testing (CMR-ET) with incremental supine in-scanner cycling at 50, 70, and 90 W
C
Comparator
Matched healthy controls undergoing the same CPET and CMR-ET protocol
O
Outcome
Differences in CPET capacity, pulmonary blood flow (Qp), and right/left ventricular function between cTOF and controls, and correlations between CPET and CMR-ET parameterssurrogate

Impaired exercise capacity in corrected tetralogy of Fallot is associated with both right and left ventricular dysfunction, suggesting CMR-ET-derived LV function could help stratify patients for pulmonary valve replacement.

Cite This Study

Steinmetz et al. (2021) conducted a case-control in Repaired Tetralogy of Fallot (n=68). Repaired Tetralogy of Fallot vs. Matched healthy controls was evaluated on Cardiopulmonary exercise capacity and biventricular function on CMR-ET. Patients with repaired tetralogy of Fallot exhibited significantly lower exercise capacity, reduced pulmonary blood flow, and impaired biventricular function compared to healthy controls.

synapsesocial.com/papers/6a9cebd760ceabfff382d56fhttps://doi.org/10.1161/circimaging.120.011823
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