Biventricular shape modes discriminate pulmonary valve replacement in tetralogy of Fallot better than imaging indices.

Autor: Govil S; Department of Bioengineering, University of California San Diego, 9500 Gilman Drive, MC 0412, La Jolla, CA, 92093-0412, USA., Mauger C; Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand.; Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand., Hegde S; Department of Pediatrics, University of California San Diego, La Jolla, CA, USA.; Division of Cardiology, Rady Children's Hospital San Diego, San Diego, CA, USA., Occleshaw CJ; Department of Cardiology, Auckland District Health Board, Auckland, New Zealand., Yu X; Division of Cardiology, Rady Children's Hospital San Diego, San Diego, CA, USA., Perry JC; Department of Pediatrics, University of California San Diego, La Jolla, CA, USA.; Division of Cardiology, Rady Children's Hospital San Diego, San Diego, CA, USA., Young AA; Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand.; Department of Biomedical Engineering, King's College London, London, UK., Omens JH; Department of Bioengineering, University of California San Diego, 9500 Gilman Drive, MC 0412, La Jolla, CA, 92093-0412, USA., McCulloch AD; Department of Bioengineering, University of California San Diego, 9500 Gilman Drive, MC 0412, La Jolla, CA, 92093-0412, USA. amcculloch@ucsd.edu.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2023 Feb 09; Vol. 13 (1), pp. 2335. Date of Electronic Publication: 2023 Feb 09.
DOI: 10.1038/s41598-023-28358-w
Abstrakt: Current indications for pulmonary valve replacement (PVR) in repaired tetralogy of Fallot (rTOF) rely on cardiovascular magnetic resonance (CMR) image-based indices but are inconsistently applied, lead to mixed outcomes, and remain debated. This study aimed to test the hypothesis that specific markers of biventricular shape may discriminate differences between rTOF patients who did and did not require subsequent PVR better than standard imaging indices. In this cross-sectional retrospective study, biventricular shape models were customized to CMR images from 84 rTOF patients. A statistical atlas of end-diastolic shape was constructed using principal component analysis. Multivariate regression was used to quantify shape mode and imaging index associations with subsequent intervention status (PVR, n = 48 vs. No-PVR, n = 36), while accounting for confounders. Clustering analysis was used to test the ability of the most significant shape modes and imaging indices to discriminate PVR status as evaluated by a Matthews correlation coefficient (MCC). Geometric strain analysis was also conducted to assess shape mode associations with systolic function. PVR status correlated significantly with shape modes associated with right ventricular (RV) apical dilation and left ventricular (LV) dilation (p < 0.01), RV basal bulging and LV conicity (p < 0.05), and pulmonary valve dilation (p < 0.01). PVR status also correlated significantly with RV ejection fraction (p < 0.05) and correlated marginally with LV end-systolic volume index (p < 0.07). Shape modes discriminated subsequent PVR better than standard imaging indices (MCC = 0.49 and MCC = 0.28, respectively) and were significantly associated with RV and LV radial systolic strain. Biventricular shape modes discriminated differences between patients who did and did not require subsequent PVR better than standard imaging indices in current use. These regional features of cardiac morphology may provide insight into adaptive vs. maladaptive types of structural remodeling and point toward an improved quantitative, patient-specific assessment tool for clinical use.
(© 2023. The Author(s).)
Databáze: MEDLINE
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