Ventricular response to dobutamine stress cardiacmagnetic resonance imaging is associated with adverse outcome during 8-year follow-up in patients with repaired Tetralogy of Fallot

Autor: Eva van den Bosch, Miranda M. Snoeren, Judith A.A.E. Cuypers, Hans Breur, Nico A. Blom, Jolien W. Roos-Hesselink, Eric Boersma, Ricardo P.J. Budde, Gabriel P. Krestin, Nienke Duppen, Willem A Helbing, Saskia E. Luijnenburg, Livia Kapusta
Přispěvatelé: Pediatrics, Cardiology, Radiology & Nuclear Medicine, ACS - Heart failure & arrhythmias, Paediatric Cardiology
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
cardiac magnetic resonance imaging
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
Magnetic Resonance Imaging
Cine
Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0]
stress imaging
030204 cardiovascular system & hematology
Cardioversion
Young Adult
03 medical and health sciences
0302 clinical medicine
All institutes and research themes of the Radboud University Medical Center
Interquartile range
Cardiac magnetic resonance imaging
Internal medicine
medicine
Humans
AcademicSubjects/MED00200
Radiology
Nuclear Medicine and imaging
Prospective Studies
030212 general & internal medicine
Stress Cardiac Magnetic Resonance Imaging
Tetralogy of Fallot
Ejection fraction
medicine.diagnostic_test
business.industry
Hazard ratio
dobutamine
Original Articles
General Medicine
medicine.disease
Magnetic Resonance Imaging
congenital heart disease
Cardiology
outcome
Female
Dobutamine
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
medicine.drug
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Zdroj: European Heart Journal-Cardiovascular Imaging, 21(9), 1039-1046. Oxford University Press
European Heart Journal Cardiovascular Imaging, 21, 9, pp. 1039-1046
European Heart Journal-Cardiovascular Imaging, 21(9), 1039-1046. OXFORD UNIV PRESS
European Heart Journal Cardiovascular Imaging, 21, 1039-1046
European heart journal cardiovascular Imaging, 21(9), 1039-1046. Oxford University Press
European Heart Journal Cardiovascular Imaging
ISSN: 2047-2404
Popis: Aims The aim of this study was to evaluate the possible value of dobutamine stress cardiac magnetic resonance imaging (CMR) to predict adverse outcome in Tetralogy of Fallot (TOF) patients. Methods and results In previous prospective multicentre studies, TOF patients underwent low-dose dobutamine stress CMR (7.5 µg/kg/min). Subsequently, during regular-care patient follow-up, patients were assessed for reaching the composite endpoint (cardiac death, arrhythmia-related hospitalization, or cardioversion/ablation, VO2 max ≤65% of predicted). A normal stress response was defined as a decrease in end-systolic volume (ESV) and increase in ejection fraction. The relative parameter change during stress was calculated as relative parameter change = [(parameterstress − parameterrest)/parameterrest] * 100. The predictive value of dobutamine stress CMR for the composite endpoint was determined using time-to-event analyses (Kaplan–Meier) and Cox proportional hazard analysis. We studied 100 patients [67 (67%) male, median age at baseline CMR 17.8 years (interquartile range 13.5–34.0), age at TOF repair 0.9 years (0.6–2.1)]. After a median follow-up of 8.6 years (6.7–14.1), 10 patients reached the composite endpoint. An abnormal stress response (30% vs. 4.4%, P = 0.021) was more frequently observed in composite endpoint patients. Also in endpoint patients, the relative decrease in right ventricular ESV decreased less during stress compared with the patients without an endpoint (−17 ± 15 vs. −26 ± 13 %, P = 0.045). Multivariable analyses identified an abnormal stress response (hazard ratio 10.4; 95% confidence interval 2.5–43.7; P = 0.001) as predictor for the composite endpoint. Conclusion An abnormal ventricular response to dobutamine stress is associated with adverse outcome in patients with repaired TOF.
Databáze: OpenAIRE
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