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Cardiac Magnetic Resonance Imaging in Repaired Tetralogy of Fallot: A Longitudinal Midterm Follow-Up Study Publisher Pubmed



Houshmand G1 ; Rahmati R2, 3 ; Meftah E3, 4 ; Zarimeidani F2, 3 ; Khorgami M1 ; Ghorashi SM3 ; Fazeli A3 ; Omidi N5 ; Saedi S1 ; Motevalli M1 ; Maleki M1 ; Pouraliakbar H1
Authors
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Authors Affiliations
  1. 1. Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Students Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
  3. 3. Cardiovascular Disease Research Institute, Tehran Heart Center, Tehran University of Medical Science, Tehran, Iran
  4. 4. Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Cardiovascular Disease Research Institute, Cardiac Primary Prevention Research Center, Tehran University of Medical Science, Tehran, Iran

Source: PLoS ONE Published:2024


Abstract

Background Biventricular dysfunction is frequent in patients with repaired tetralogy of Fallot, necessitating routine imaging to monitor for worsening conditions and determine whether procedures like pulmonary valve replacement (PVR) are needed. This study aimed to highlight the parameters of cardiac magnetic resonance imaging (CMR) and their association with adverse outcomes in the midterm follow-up of these patients. Methods This longitudinal study recruited all patients with a history of tetralogy of Fallot total correction (TFTC) who had two CMR images at a minimum three-month interval at Rajaie Center from 2007 through 2017. Results Fifty-six patients at a mean age of 15.23 ± 11.66 years at TFTC and a 1:1 gender distribution were assessed. Regarding adverse events, PVR was done on 18 patients (32%). Right and left ventricular dysfunction occurred in 43 (76.8%) and 18 (32.1%) patients, respectively. Death did not occur in the present study. RVOT fibrosis was present in 47 (92.2%). The stroke volume of both ventricles increased during the follow-up (P <0.05), although end-diastolic volume indices, end-systolic volume indices, ejection fractions, strain parameters, and ventriculoarterial coupling did not change significantly. Patients requiring PVR had a significantly higher end-systolic volume index in both ventricles (P <0.05) and a lower right-sided ejection fraction (P <0.01) and coupling ratio (P <0.05). The ejection fraction in the left ventricle correlated with global circumferential strain (P <0.01), while in the right ventricle, it correlated with global longitudinal strain (P <0.05) and the right-sided coupling ratio (P <0.01). Conclusion Myocardial strain and ventriculoarterial coupling parameters could underscore personalized-approached therapy and follow-up to improve outcomes. © 2024 Houshmand et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.