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Repaired tetralogy of Fallot: ratio of right ventricular volume to left ventricular volume as a marker of right ventricular dilatation.
Radiology. 2012 Oct; 265(1):78-86.R

Abstract

PURPOSE

To compare indexed right ventricular (RV) end-diastolic volume (RVEDVi) and the ratio of RV volume to left ventricular (LV) volume (RV/LV ratio) in prediction of significant pulmonary regurgitation (PR) after tetralogy of Fallot (TOF) repair and to assess sex differences in the RV/LV ratio.

MATERIALS AND METHODS

The ethics committee approved this retrospective single-center study, and patients or their parents or guardians signed written informed consent. RVEDVi, RV/LV ratio, and PR were measured with the use of magnetic resonance imaging in 155 consecutive patients with repaired TOF (mean age, 29.2 years±10.9 [standard deviation]; 98 [63.2%] male and 57 [36.8%] female patients). PR fraction of 20% or greater was considered significant. The capability of the RVEDVi and that of the RV/LV ratio for prediction of significant PR were compared by using logistic regression analysis and receiver operating characteristic curve analysis.

RESULTS

RVEDVi was significantly higher in male (162.8 mL/m2±50.4) than in female (138.2 mL/m2±37.5) patients (P=.001). Conversely, the RV/LV ratio was similar in both sexes (1.82±0.56 [male] vs 1.69±0.46 [female], P=.13) both in the entire cohort and after excluding patients with significant (≥30 mm Hg) RV outflow tract gradient and/or other residual hemodynamic abnormalities (P=.63). Receiver operating characteristic analysis revealed better discrimination of significant (≥20%) from insignificant (<20%) PR with the use of the RV/LV ratio than with RVEDVi (area under the receiver operating characteristic curve, 0.937 [model 4] vs 0.849 [model 1], P=.01). In multivariate analysis, the only independent predictor of PR fraction was the RV/LV ratio.

CONCLUSION

The RV/LV ratio is more accurate than the RVEDVi in differentiation of significant from insignificant PR. After TOF repair, female and male patients have similar RV/LV ratios despite significant differences in RVEDVi between the sexes.

Authors+Show Affiliations

Department of Coronary Artery Disease and Structural Heart Diseases, Cardiac Magnetic Resonance Unit, Institute of Cardiology, ul Alpejska 42, 04-628 Warsaw, Poland. mspiewak@ikard.plNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22771877

Citation

Spiewak, Mateusz, et al. "Repaired Tetralogy of Fallot: Ratio of Right Ventricular Volume to Left Ventricular Volume as a Marker of Right Ventricular Dilatation." Radiology, vol. 265, no. 1, 2012, pp. 78-86.
Spiewak M, Małek ŁA, Petryka J, et al. Repaired tetralogy of Fallot: ratio of right ventricular volume to left ventricular volume as a marker of right ventricular dilatation. Radiology. 2012;265(1):78-86.
Spiewak, M., Małek, Ł. A., Petryka, J., Mazurkiewicz, Ł., Werys, K., Biernacka, E. K., Kowalski, M., Hoffman, P., Demkow, M., Miśko, J., & Ruzyłło, W. (2012). Repaired tetralogy of Fallot: ratio of right ventricular volume to left ventricular volume as a marker of right ventricular dilatation. Radiology, 265(1), 78-86.
Spiewak M, et al. Repaired Tetralogy of Fallot: Ratio of Right Ventricular Volume to Left Ventricular Volume as a Marker of Right Ventricular Dilatation. Radiology. 2012;265(1):78-86. PubMed PMID: 22771877.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Repaired tetralogy of Fallot: ratio of right ventricular volume to left ventricular volume as a marker of right ventricular dilatation. AU - Spiewak,Mateusz, AU - Małek,Łukasz A, AU - Petryka,Joanna, AU - Mazurkiewicz,Łukasz, AU - Werys,Konrad, AU - Biernacka,Elzbieta K, AU - Kowalski,Mirosław, AU - Hoffman,Piotr, AU - Demkow,Marcin, AU - Miśko,Jolanta, AU - Ruzyłło,Witold, Y1 - 2012/07/06/ PY - 2012/7/10/entrez PY - 2012/7/10/pubmed PY - 2012/12/10/medline SP - 78 EP - 86 JF - Radiology JO - Radiology VL - 265 IS - 1 N2 - PURPOSE: To compare indexed right ventricular (RV) end-diastolic volume (RVEDVi) and the ratio of RV volume to left ventricular (LV) volume (RV/LV ratio) in prediction of significant pulmonary regurgitation (PR) after tetralogy of Fallot (TOF) repair and to assess sex differences in the RV/LV ratio. MATERIALS AND METHODS: The ethics committee approved this retrospective single-center study, and patients or their parents or guardians signed written informed consent. RVEDVi, RV/LV ratio, and PR were measured with the use of magnetic resonance imaging in 155 consecutive patients with repaired TOF (mean age, 29.2 years±10.9 [standard deviation]; 98 [63.2%] male and 57 [36.8%] female patients). PR fraction of 20% or greater was considered significant. The capability of the RVEDVi and that of the RV/LV ratio for prediction of significant PR were compared by using logistic regression analysis and receiver operating characteristic curve analysis. RESULTS: RVEDVi was significantly higher in male (162.8 mL/m2±50.4) than in female (138.2 mL/m2±37.5) patients (P=.001). Conversely, the RV/LV ratio was similar in both sexes (1.82±0.56 [male] vs 1.69±0.46 [female], P=.13) both in the entire cohort and after excluding patients with significant (≥30 mm Hg) RV outflow tract gradient and/or other residual hemodynamic abnormalities (P=.63). Receiver operating characteristic analysis revealed better discrimination of significant (≥20%) from insignificant (<20%) PR with the use of the RV/LV ratio than with RVEDVi (area under the receiver operating characteristic curve, 0.937 [model 4] vs 0.849 [model 1], P=.01). In multivariate analysis, the only independent predictor of PR fraction was the RV/LV ratio. CONCLUSION: The RV/LV ratio is more accurate than the RVEDVi in differentiation of significant from insignificant PR. After TOF repair, female and male patients have similar RV/LV ratios despite significant differences in RVEDVi between the sexes. SN - 1527-1315 UR - https://www.unboundmedicine.com/medline/citation/22771877/Repaired_tetralogy_of_Fallot:_ratio_of_right_ventricular_volume_to_left_ventricular_volume_as_a_marker_of_right_ventricular_dilatation_ L2 - https://pubs.rsna.org/doi/10.1148/radiol.12120051?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -