TY - JOUR
T1 - Long-term assessment of clinical outcomes and disease progression in patients with corrected Tetralogy of Fallot
AU - Ali, L. A.
AU - Gentili, F.
AU - Festa, P.
AU - Perrone, Marco Alfonso
AU - Curione, D.
AU - Caputo, M.
AU - Wald, R.
AU - Secinaro, A.
AU - Carotti, A.
AU - Chinali, M.
AU - Marrone, C.
AU - Pak, V.
AU - Federici, D.
AU - Gagliardi, M. G.
AU - Bianco, Massimiliano
AU - Galletti, L.
AU - Drago, F.
AU - Leonardi, B.
PY - 2021
Y1 - 2021
N2 - OBJECTIVE: Understanding changes of right ventricular (RV) geometry and function in repaired Tetralogy of Fallot (rToF) patients can improve decision-making for pulmonary valve replacement. Therefore, we aimed to assess the magnitude and clinical correlations of RV changes in rToF patients.PATIENTS AND METHODS: Clinical and MRI data of rToF patients who underwent repeated cardiac magnetic resonance imaging (MRI) at two centers between December 2003 and September 2020 were analyzed together with anatomical factors, including RV outflow tract obstruction, pulmonary artery branch stenosis, and tricuspid regurgitation. Adverse cardiac events and/or NYHA class worsening were documented and correlated with MRI changes. ORS length was reported at each MRI.RESULTS: Two-hundred-and-nineteen rToF patients (53% males, aged 20.2 +/- 10.1 years) were enrolled. An increase of ventricular dimensions, except LVEDVi, and worsening of right and left ejection fractions were found over an average period of 5 years of follow-up. These changes were statistically significant but within 10% of the initial value. No significant changes were reported on a year-to-year basis, except in a small group of patients (6%) in whom no predictive factors were identified. Despite similar RV dimensions at the first examination, younger patients had a higher RV ejection fraction and a different annual rate of change of ventricular dimensions compared to older ones. Patients with arrhythmias (20%) were more frequently older and had larger RV dimensions but showed no significant correlations with MRI changes/years.CONCLUSIONS: Changes in RV dimensions and function occur rarely and very slowly in rToF patients. A small percentage of patients experience a significant worsening in a short time interval without any recognized risk factors. Arrhythmias appear to occur in a small percentage of cases in the late follow-up.
AB - OBJECTIVE: Understanding changes of right ventricular (RV) geometry and function in repaired Tetralogy of Fallot (rToF) patients can improve decision-making for pulmonary valve replacement. Therefore, we aimed to assess the magnitude and clinical correlations of RV changes in rToF patients.PATIENTS AND METHODS: Clinical and MRI data of rToF patients who underwent repeated cardiac magnetic resonance imaging (MRI) at two centers between December 2003 and September 2020 were analyzed together with anatomical factors, including RV outflow tract obstruction, pulmonary artery branch stenosis, and tricuspid regurgitation. Adverse cardiac events and/or NYHA class worsening were documented and correlated with MRI changes. ORS length was reported at each MRI.RESULTS: Two-hundred-and-nineteen rToF patients (53% males, aged 20.2 +/- 10.1 years) were enrolled. An increase of ventricular dimensions, except LVEDVi, and worsening of right and left ejection fractions were found over an average period of 5 years of follow-up. These changes were statistically significant but within 10% of the initial value. No significant changes were reported on a year-to-year basis, except in a small group of patients (6%) in whom no predictive factors were identified. Despite similar RV dimensions at the first examination, younger patients had a higher RV ejection fraction and a different annual rate of change of ventricular dimensions compared to older ones. Patients with arrhythmias (20%) were more frequently older and had larger RV dimensions but showed no significant correlations with MRI changes/years.CONCLUSIONS: Changes in RV dimensions and function occur rarely and very slowly in rToF patients. A small percentage of patients experience a significant worsening in a short time interval without any recognized risk factors. Arrhythmias appear to occur in a small percentage of cases in the late follow-up.
KW - Tetralogy of Fallot
KW - Repaired tetralogy of Fallot
KW - Right ventricle
KW - Cardiac magnetic resonance
KW - Tetralogy of Fallot
KW - Repaired tetralogy of Fallot
KW - Right ventricle
KW - Cardiac magnetic resonance
UR - http://hdl.handle.net/10807/229494
U2 - 10.26355/eurrev_202110_27000
DO - 10.26355/eurrev_202110_27000
M3 - Article
SN - 2284-0729
VL - 25
SP - 6300
EP - 6310
JO - European Review for Medical and Pharmacological Sciences
JF - European Review for Medical and Pharmacological Sciences
ER -