Three-dimensional analysis of regional right ventricular shape and function in repaired tetralogy of Fallot using cardiovascular magnetic resonance

S. Javed Zaidi, Waseem Cossor, Amita Singh, Francesco Maffesanti, Keigo Kawaji, Joyce Woo, Victor Mor-Avi, David A. Roberson, Shelby Kutty, Amit R. Patel

Research output: Contribution to journalArticle

Abstract

Background: Patients with surgically repaired tetralogy of Fallot (rTOF) often have residual pulmonic valve regurgitation, leading to abnormal remodeling and dysfunction of the right ventricle often requiring pulmonic valve replacement. We tested the hypothesis that 3D analysis of right ventricular (RV) shape and function may reveal differences in regional adaptive remodeling that occurs in patients with rTOF, depending on whether a transannular patch (TAP) was utilized. Methods: Forty patients with rTOF who underwent cardiac magnetic resonance imaging (1.5 T), including 20 with and 20 without TAP, and 10 normal controls were studied. Images were analyzed to measure RV endocardial curvature and global and regional volume and function. Results: RV ejection fraction (EF) was 42 ± 11% in TAP and 38 ± 9% in no-TAP (p = 0.19), both lower than 54 ± 3% in controls (p < 0.01). Left ventricular (LV) EF was 54 ± 9% in TAP, 54 ± 8% in no-TAP (p = 0.87) and 61 ± 16% in controls (both p < 0.01). Indexed LV end-diastolic volumes were higher in no-TAP than in TAP subgroup (p = 0.02). With TAP, mid RV septum showed lower curvature during diastole (less convex), than the mid and apical free walls and free wall adjacent to the RV outflow tract (RVOT; more convex). There were no differences in curvature during systole between rTOF subgroups but mid and RVOT free walls showed higher curvature versus controls. Conclusions: This is the first study to comprehensively describe the influence of TAP on changes in regional RV shape in patients with rTOF. Understanding these differences may help guide therapeutic options for residual pulmonary valve regurgitation in rTOF patients.

Original languageEnglish (US)
Pages (from-to)106-112
Number of pages7
JournalClinical Imaging
Volume52
DOIs
StatePublished - Nov 1 2018

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Right Ventricular Function
Tetralogy of Fallot
Magnetic Resonance Spectroscopy
Stroke Volume
Pulmonary Valve Insufficiency
Ventricular Septum
Lung
Diastole
Systole
Heart Ventricles
Magnetic Resonance Imaging

Keywords

  • 3D shape analysis
  • Congenital heart disease
  • Pulmonary valve
  • Right ventricle
  • Transannular patch

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Three-dimensional analysis of regional right ventricular shape and function in repaired tetralogy of Fallot using cardiovascular magnetic resonance. / Zaidi, S. Javed; Cossor, Waseem; Singh, Amita; Maffesanti, Francesco; Kawaji, Keigo; Woo, Joyce; Mor-Avi, Victor; Roberson, David A.; Kutty, Shelby; Patel, Amit R.

In: Clinical Imaging, Vol. 52, 01.11.2018, p. 106-112.

Research output: Contribution to journalArticle

Zaidi, S. Javed ; Cossor, Waseem ; Singh, Amita ; Maffesanti, Francesco ; Kawaji, Keigo ; Woo, Joyce ; Mor-Avi, Victor ; Roberson, David A. ; Kutty, Shelby ; Patel, Amit R. / Three-dimensional analysis of regional right ventricular shape and function in repaired tetralogy of Fallot using cardiovascular magnetic resonance. In: Clinical Imaging. 2018 ; Vol. 52. pp. 106-112.
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abstract = "Background: Patients with surgically repaired tetralogy of Fallot (rTOF) often have residual pulmonic valve regurgitation, leading to abnormal remodeling and dysfunction of the right ventricle often requiring pulmonic valve replacement. We tested the hypothesis that 3D analysis of right ventricular (RV) shape and function may reveal differences in regional adaptive remodeling that occurs in patients with rTOF, depending on whether a transannular patch (TAP) was utilized. Methods: Forty patients with rTOF who underwent cardiac magnetic resonance imaging (1.5 T), including 20 with and 20 without TAP, and 10 normal controls were studied. Images were analyzed to measure RV endocardial curvature and global and regional volume and function. Results: RV ejection fraction (EF) was 42 ± 11{\%} in TAP and 38 ± 9{\%} in no-TAP (p = 0.19), both lower than 54 ± 3{\%} in controls (p < 0.01). Left ventricular (LV) EF was 54 ± 9{\%} in TAP, 54 ± 8{\%} in no-TAP (p = 0.87) and 61 ± 16{\%} in controls (both p < 0.01). Indexed LV end-diastolic volumes were higher in no-TAP than in TAP subgroup (p = 0.02). With TAP, mid RV septum showed lower curvature during diastole (less convex), than the mid and apical free walls and free wall adjacent to the RV outflow tract (RVOT; more convex). There were no differences in curvature during systole between rTOF subgroups but mid and RVOT free walls showed higher curvature versus controls. Conclusions: This is the first study to comprehensively describe the influence of TAP on changes in regional RV shape in patients with rTOF. Understanding these differences may help guide therapeutic options for residual pulmonary valve regurgitation in rTOF patients.",
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T1 - Three-dimensional analysis of regional right ventricular shape and function in repaired tetralogy of Fallot using cardiovascular magnetic resonance

AU - Zaidi, S. Javed

AU - Cossor, Waseem

AU - Singh, Amita

AU - Maffesanti, Francesco

AU - Kawaji, Keigo

AU - Woo, Joyce

AU - Mor-Avi, Victor

AU - Roberson, David A.

AU - Kutty, Shelby

AU - Patel, Amit R.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: Patients with surgically repaired tetralogy of Fallot (rTOF) often have residual pulmonic valve regurgitation, leading to abnormal remodeling and dysfunction of the right ventricle often requiring pulmonic valve replacement. We tested the hypothesis that 3D analysis of right ventricular (RV) shape and function may reveal differences in regional adaptive remodeling that occurs in patients with rTOF, depending on whether a transannular patch (TAP) was utilized. Methods: Forty patients with rTOF who underwent cardiac magnetic resonance imaging (1.5 T), including 20 with and 20 without TAP, and 10 normal controls were studied. Images were analyzed to measure RV endocardial curvature and global and regional volume and function. Results: RV ejection fraction (EF) was 42 ± 11% in TAP and 38 ± 9% in no-TAP (p = 0.19), both lower than 54 ± 3% in controls (p < 0.01). Left ventricular (LV) EF was 54 ± 9% in TAP, 54 ± 8% in no-TAP (p = 0.87) and 61 ± 16% in controls (both p < 0.01). Indexed LV end-diastolic volumes were higher in no-TAP than in TAP subgroup (p = 0.02). With TAP, mid RV septum showed lower curvature during diastole (less convex), than the mid and apical free walls and free wall adjacent to the RV outflow tract (RVOT; more convex). There were no differences in curvature during systole between rTOF subgroups but mid and RVOT free walls showed higher curvature versus controls. Conclusions: This is the first study to comprehensively describe the influence of TAP on changes in regional RV shape in patients with rTOF. Understanding these differences may help guide therapeutic options for residual pulmonary valve regurgitation in rTOF patients.

AB - Background: Patients with surgically repaired tetralogy of Fallot (rTOF) often have residual pulmonic valve regurgitation, leading to abnormal remodeling and dysfunction of the right ventricle often requiring pulmonic valve replacement. We tested the hypothesis that 3D analysis of right ventricular (RV) shape and function may reveal differences in regional adaptive remodeling that occurs in patients with rTOF, depending on whether a transannular patch (TAP) was utilized. Methods: Forty patients with rTOF who underwent cardiac magnetic resonance imaging (1.5 T), including 20 with and 20 without TAP, and 10 normal controls were studied. Images were analyzed to measure RV endocardial curvature and global and regional volume and function. Results: RV ejection fraction (EF) was 42 ± 11% in TAP and 38 ± 9% in no-TAP (p = 0.19), both lower than 54 ± 3% in controls (p < 0.01). Left ventricular (LV) EF was 54 ± 9% in TAP, 54 ± 8% in no-TAP (p = 0.87) and 61 ± 16% in controls (both p < 0.01). Indexed LV end-diastolic volumes were higher in no-TAP than in TAP subgroup (p = 0.02). With TAP, mid RV septum showed lower curvature during diastole (less convex), than the mid and apical free walls and free wall adjacent to the RV outflow tract (RVOT; more convex). There were no differences in curvature during systole between rTOF subgroups but mid and RVOT free walls showed higher curvature versus controls. Conclusions: This is the first study to comprehensively describe the influence of TAP on changes in regional RV shape in patients with rTOF. Understanding these differences may help guide therapeutic options for residual pulmonary valve regurgitation in rTOF patients.

KW - 3D shape analysis

KW - Congenital heart disease

KW - Pulmonary valve

KW - Right ventricle

KW - Transannular patch

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