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Relation of right ventricular dilation, age of repair, and restrictive right ventricular physiology with patient-reported quality of life in adolescents and adults with repaired tetralogy of fallot.
Am J Cardiol. 2010 Dec 15; 106(12):1798-802.AJ

Abstract

The present study aimed to determine the predictors of patient-reported quality of life and restrictive right ventricular (RV) physiology in adolescents and adults with repaired tetralogy of Fallot. A total of 62 patients (median age 28.5 years, range 14 to 69) undergoing cardiovascular magnetic resonance imaging completed the Short Form 36-item questionnaire, version 2, a validated quality of life assessment. RV inflow curves were generated from the sum of tricuspid inflow and pulmonary insufficiency. The patient-reported quality of life was comparable to population norms. Patients repaired after 1 year of age showed a strong trend toward a greater likelihood of physical component summary age-adjusted z-score ≤-1 (odds ratio 7.50, 95% confidence interval 0.90 to 62.3, p = 0.06). Patients with a RV ejection fraction of <45% reported decreased physical component summary (p = 0.02) and physical functioning (p = 0.02) scores. The RV end-diastolic volume, pulmonary regurgitation, and diastolic indexes did not predict the quality of life. The indexed RV end-diastolic volume was related to diastolic abnormalities, correlating with a greater peak early filling rate (r = 0.71, p <0.0001), ratio of peak early to atrial filling rates (r = 0.45, p = 0.006), and showing a strong trend with the end-diastolic forward flow in the pulmonary trunk (odds ratio 2.67 for moderate dilation and 3.50 for severe dilation, p = 0.06). Patients who underwent repair before 1 year old were more likely to have end-diastolic forward flow (15 of 17 vs 25 of 42, p = 0.03). In conclusion, the RV ejection fraction and age of repair were the best predictors of quality of life in this population, in whom end-diastolic forward flow and associated diastolic parameters appeared to reflect an overdistended ventricle, which might suggest a role for early pulmonary valve replacement.

Authors+Show Affiliations

Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, USA. jimmyl@umich.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21126623

Citation

Lu, Jimmy C., et al. "Relation of Right Ventricular Dilation, Age of Repair, and Restrictive Right Ventricular Physiology With Patient-reported Quality of Life in Adolescents and Adults With Repaired Tetralogy of Fallot." The American Journal of Cardiology, vol. 106, no. 12, 2010, pp. 1798-802.
Lu JC, Cotts TB, Agarwal PP, et al. Relation of right ventricular dilation, age of repair, and restrictive right ventricular physiology with patient-reported quality of life in adolescents and adults with repaired tetralogy of fallot. Am J Cardiol. 2010;106(12):1798-802.
Lu, J. C., Cotts, T. B., Agarwal, P. P., Attili, A. K., & Dorfman, A. L. (2010). Relation of right ventricular dilation, age of repair, and restrictive right ventricular physiology with patient-reported quality of life in adolescents and adults with repaired tetralogy of fallot. The American Journal of Cardiology, 106(12), 1798-802. https://doi.org/10.1016/j.amjcard.2010.08.021
Lu JC, et al. Relation of Right Ventricular Dilation, Age of Repair, and Restrictive Right Ventricular Physiology With Patient-reported Quality of Life in Adolescents and Adults With Repaired Tetralogy of Fallot. Am J Cardiol. 2010 Dec 15;106(12):1798-802. PubMed PMID: 21126623.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relation of right ventricular dilation, age of repair, and restrictive right ventricular physiology with patient-reported quality of life in adolescents and adults with repaired tetralogy of fallot. AU - Lu,Jimmy C, AU - Cotts,Timothy B, AU - Agarwal,Prachi P, AU - Attili,Anil K, AU - Dorfman,Adam L, Y1 - 2010/11/02/ PY - 2010/05/18/received PY - 2010/08/11/revised PY - 2010/08/11/accepted PY - 2010/12/4/entrez PY - 2010/12/4/pubmed PY - 2011/2/1/medline SP - 1798 EP - 802 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 106 IS - 12 N2 - The present study aimed to determine the predictors of patient-reported quality of life and restrictive right ventricular (RV) physiology in adolescents and adults with repaired tetralogy of Fallot. A total of 62 patients (median age 28.5 years, range 14 to 69) undergoing cardiovascular magnetic resonance imaging completed the Short Form 36-item questionnaire, version 2, a validated quality of life assessment. RV inflow curves were generated from the sum of tricuspid inflow and pulmonary insufficiency. The patient-reported quality of life was comparable to population norms. Patients repaired after 1 year of age showed a strong trend toward a greater likelihood of physical component summary age-adjusted z-score ≤-1 (odds ratio 7.50, 95% confidence interval 0.90 to 62.3, p = 0.06). Patients with a RV ejection fraction of <45% reported decreased physical component summary (p = 0.02) and physical functioning (p = 0.02) scores. The RV end-diastolic volume, pulmonary regurgitation, and diastolic indexes did not predict the quality of life. The indexed RV end-diastolic volume was related to diastolic abnormalities, correlating with a greater peak early filling rate (r = 0.71, p <0.0001), ratio of peak early to atrial filling rates (r = 0.45, p = 0.006), and showing a strong trend with the end-diastolic forward flow in the pulmonary trunk (odds ratio 2.67 for moderate dilation and 3.50 for severe dilation, p = 0.06). Patients who underwent repair before 1 year old were more likely to have end-diastolic forward flow (15 of 17 vs 25 of 42, p = 0.03). In conclusion, the RV ejection fraction and age of repair were the best predictors of quality of life in this population, in whom end-diastolic forward flow and associated diastolic parameters appeared to reflect an overdistended ventricle, which might suggest a role for early pulmonary valve replacement. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/21126623/Relation_of_right_ventricular_dilation_age_of_repair_and_restrictive_right_ventricular_physiology_with_patient_reported_quality_of_life_in_adolescents_and_adults_with_repaired_tetralogy_of_fallot_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(10)01629-2 DB - PRIME DP - Unbound Medicine ER -