Longitudinal changes in adolescents with TOF: implications for care
| Autor: | Stephen M. Paridon, Xuemei Zhang, Michael G. McBride, Elizabeth Goldmuntz, Matthew A. Harris, Misha Bhat, Justine Shults, Laura Mercer-Rosa, Mark A. Fogel |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Adolescent Ventricular Dysfunction Right Diastole Magnetic Resonance Imaging Cine Pulmonary insufficiency 030204 cardiovascular system & hematology Cohort Studies Electrocardiography 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Cardiac magnetic resonance imaging Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Longitudinal Studies 030212 general & internal medicine Cardiac Surgical Procedures Systole Monitoring Physiologic Retrospective Studies Tetralogy of Fallot Exercise Tolerance medicine.diagnostic_test business.industry Stroke Volume Magnetic resonance imaging General Medicine Original Articles medicine.disease medicine.anatomical_structure Pulmonary valve Heart Function Tests Regurgitant fraction Exercise Test Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Popis: | Background We sought to identify predictors of change in right ventricular function and exercise capacity in adolescents following repair for tetralogy of Fallot. Methods and results We performed a longitudinal study with serial cardiac magnetic resonance imaging and/or exercise stress tests. Patients with interim intervention on the pulmonary valve were excluded. Paired t-test was used to detect longitudinal changes and multivariable regression models were built to identify predictors of change. Initial and follow up magnetic resonance and exercise stress test studies were available for 65 and 63 subjects, respectively. Age at initial testing was 11.7 ± 2.7 years. Average follow up time was 4.5 ± 1.8 (magnetic resonance) and 4.0 ± 1.6 (exercise test) years. There was a significant increase in right ventricular end diastolic and systolic volume (119 ± 34 to 128 ± 35 ml/m2, P = 0.006; 49 ± 20 to 56 ± 23 ml/m2, P = 0.001, respectively), and a decrease in right ventricular ejection fraction (60 ± 7 to 56 ± 8%, P = 0.001), with no significant change in pulmonary regurgitant fraction or right ventricular cardiac index. Predictors of right ventricular dilation over time included: Time elapsed from surgical repair, severity of pulmonary insufficiency and right ventricular dilation at the initial magnetic resonance imaging. Of those, time elapsed from surgical repair had the most significant effect. There was no change in exercise capacity. Discussion In the adolescent with tetralogy of Fallot, longer time from surgery, more pulmonary insufficiency and greater right ventricular dilation at initial magnetic resonance imaging are associated with progressive right ventricular dilation. These results suggest early monitoring with magnetic resonance imaging might identify those at highest risk for progressive disease. Published on behalf of the European Society of Cardiology. All rights reserved. (Less) |
| Databáze: | OpenAIRE |
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