Differential Effect of the Ratio of Right Ventricular Volume to Left Ventricular Volume in Children with Repaired Tetralogy of Fallot

Yao, Qiang; Hu, Xihong; Shen, Quanli; Zhang, Qiao; Pa, Mi-Er; Qian, Bin; Yan, Weili; Huang, Guoying

doi:10.1159/000441291

Cited by 8 publications

(7 citation statements)

References 19 publications

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“…The EDV ratio has previously been successfully applied to predict the severity of pulmonary regurgitation in humans (22,26) and proposed as a marker for improved detection of RV enlargement in patients with pulmonary arterial hypertension (2). We show that pronounced congestion causes severe RV dilatation resulting in a pseudonormalization of the EDV ratio.…”

Section: Cluster Analysismentioning

confidence: 79%

Noninvasive stratification of postinfarction rats based on the degree of cardiac dysfunction using magnetic resonance imaging and echocardiography

Aronsen

Espe

Skårdal

et al. 2017

American Journal of Physiology-Heart and Circulatory Physiology

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The myocardial infarction (MI) rat model plays a crucial role in modern cardiovascular research, but the inherent heterogeneity of this model represents a challenge. We sought to identify subgroups among the post-MI rats and establish simple noninvasive stratification protocols for such subgroups. Six weeks after induction of MI, 49 rats underwent noninvasive examinations using magnetic resonance imaging (MRI) and echocardiography. Twelve sham-operated rats served as controls. Increased end-diastolic left ventricular (LV) pressure and lung weight served as indicators for congestive heart failure (CHF). A clustering algorithm using 13 noninvasive and invasive parameters was used to identify distinct groups among the animals. The cluster analysis revealed four distinct post-MI phenotypes; two without congestion but with different degree of LV dilatation, and two with different degree of congestion and right ventricular (RV) affection. Among the MRI parameters, RV mass emerged as robust noninvasive marker of CHF with 100% specificity/sensitivity. Moreover, LV infarct size and RV ejection fraction further predicted subgroup among the non-CHF and CHF rats with excellent specificity/sensitivity. Of the echocardiography parameters, left atrial diameter predicted CHF. Moreover, LV end-diastolic diameter predicted the subgroups among the non-CHF rats. We propose two simple noninvasive schemes to stratify post-MI rats, based on the degree of heart failure; one for MRI and one for echocardiography. In vivo phenotyping of rats is essential for robust and reliable data. Here, we present two simple noninvasive schemes for the stratification of postinfarction rats based on the degree of heart failure: one using magnetic resonance imaging and one based on echocardiography.

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Section: Cluster Analysismentioning

confidence: 79%

Noninvasive stratification of postinfarction rats based on the degree of cardiac dysfunction using magnetic resonance imaging and echocardiography

Aronsen

Espe

Skårdal

et al. 2017

American Journal of Physiology-Heart and Circulatory Physiology

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“…Povećanje pritiska i volumena desne komore je povezano sa zaravnjenjem interventrikularnog septuma što rezultira u otežanom dijastolnom punjenju lijeve komore. Stoga je odnos volumena desne i lijeve komore, koji uključuje parametar neželjenih efekata pulmonalne regurgitacije na dilataciju desne komore i kompresiju lijeve komore, značajan prediktor težine pulmonalne regurgitacije i disfunkcije desnog i lijevog srca [22][23][24].…”

Section: Rezidualne Postoperativne Sekveleunclassified

Clinical characteristics, prognosis and outcome of patients with repaired tetralogy of Fallot

Milinković¹,

Bokonjić²,

Joksimović³

et al. 2019

Biomedicinska istraž.

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Napredak u dijagnostici i liječenju doveli su do značajnog poboljšanja sudbinedjece rođene sa tetralogijom Fallot sa perioperativnim mortalitetomod 2-3% i tridesetogodišnjom stopom preživljavanja od 90%. Ipak, većinaovih pacijenata ima rezidualne postoperativne morfološke i hemodinamskeporemećaje kao i poremećaje srčanog ritma, prvenstveno zbog volumenaopterećenja desne komore uzrokovanog hroničnom pulmonalnomregurgitacijom. Unaprijeđene hirurške procedure smanjile su ranu smrtnostna manje od 3%, ali se godišnja stopa smrtnosti višestruko povećava20-30 godina nakon inicijalne hirurške sanacije, uglavnom zbog neželjenihkardioloških događaja. U longitudinalnom praćenju pacijenata poslijeoperacije tetralogije Fallot veliki značaj ima rano otkrivanje morfoloških ihemodinamskih rezidualnih poremećaja kako kod asimptomskih tako ipacijenata sa simptomima radi pravovremenog opredjeljenja za nove terapijskemjere (npr. zamjena pulmonalne valvule), a sve u cilju poboljšanjatoka i ishoda liječenja. Magnetna rezonanca srca je dijagnostička metodakoja pruža najprecizniju i najtačniju procjenu pojedinih parametara srčanedisfunkcije i loših ishoda kao i definisanje prediktivne vrijednosti pojedinihparametara. Dosadašnja brojna istraživanja svjedoče da je povećanje rizikasmrtnosti povezano sa progresivnom dilatacijom i disfunkcijom desnekomore, a preko ventrikulo-ventrikularne interreakcije i disfunkcijom lijevekomore. Identifikаcijа pаrаmetаrа, koji mogu dа predvide rizik zа budućeneželjene kаrdijаlne dogаđаje kao što su ventrikularna tahikardija i srčanainsuficiencija, može da pomogne prilаgođаvаnju terаpijskog pristupа, kojibi vodio unаpređenju kvaliteta života i preživljаvаnjа bolesnikа.

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“…Pulmonary regurgitation (PR) is the most common complication in patients with TOF surgery, which is associated with progressive dilatation and impaired right ventricular systolic function (RV), and it adversely affects left heart function and geometry due to unfavorable ventriculo-ventricular interaction [5][6][7][8][9][10][11]. The ratio of right and left ventricular volume is a significant predictor of PR severity and right and left heart dysfunction [12][13][14]. Therefore, surgical replacement of the pulmonary valve is associated with a significant reduction in RV volume and an increase in right and left ventricular systolic function, shortening the duration of the QRS complex, improving symptoms, and NYHA functional class [15].…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging of the heart as a method of long-term monitoring of right heart function after tetralogy of Fallot surgery

Milinković¹,

Marić²,

Bokonjić³

et al. 2022

Biomedicinska istraž.

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Introduction. Cardiac magnetic resonance imaging (CMR) is considered the reference diagnostic method for quantifying right ventricular size and function, and pulmonary regurgitation in patients with tetralogy of Fallot surgery. The aim of this paper is to confirm the importance of magnetic resonance continuous postoperative monitoring of right and left heart function parameters as a diagnostic method that provides the most precise and accurate assessment.Methods. The prospective observational study included subjects with TOF surgery who were diagnosed with residual morphological and/or functional disorders on control postoperative echocardiographic examinations. All subjects underwent magnetic resonance imaging of the heart on a 1.5 T scanner with dedicated coils for the heart surface according to the standard protocol for a period of one year from the beginning of the study. Criteria for exclusion from the study were: significant residual pulmonary stenosis, condition after pulmonary valve replacement, existence of residual shunt lesions, contraindications for cardiac magnetic resonance imaging (pacemaker, ICD, claustrophobia). Depending on the time elapsed since the tetralogy of Fallot surgery, the subjects were divided into groups: more than 15 years, 11−15 years, 6−10 years, less than 5 years. Results.The study included 131 subjects with an average age of 24.18 ± 11.57 years with complete correction of TOF. Intergroup differences in values of right ventricular end-diastolic volume, right ventricular ejection fraction, and left ventricular ejection fraction were demonstrated, but there was no statistically significant intergroup difference in values of pulmonary regurgitation fraction. The negative interaction of the right and left ventricles intensifies during the years of follow-up of patients after TOF surgery, which is especially true fifteen years after surgery. Conclusion.CMR has the most significant role in research efforts aimed at improving the outcomes of operated patients with tetralogy of Fallot.

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Differential Effect of the Ratio of Right Ventricular Volume to Left Ventricular Volume in Children with Repaired Tetralogy of Fallot

Cited by 8 publications

References 19 publications

Noninvasive stratification of postinfarction rats based on the degree of cardiac dysfunction using magnetic resonance imaging and echocardiography

Noninvasive stratification of postinfarction rats based on the degree of cardiac dysfunction using magnetic resonance imaging and echocardiography

Clinical characteristics, prognosis and outcome of patients with repaired tetralogy of Fallot

Magnetic resonance imaging of the heart as a method of long-term monitoring of right heart function after tetralogy of Fallot surgery

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