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Factors associated with right ventricular dilatation and dysfunction in patients with chronic pulmonary regurgitation after repair of tetralogy of Fallot: analysis of magnetic resonance imaging data from 218 patients.
J Thorac Cardiovasc Surg. 2014 Dec; 148(6):2589-95.JT

Abstract

OBJECTIVE

The aim of the present study was to identify the factors associated with right ventricular (RV) dilatation and dysfunction in patients with chronic pulmonary regurgitation (PR) after repair of tetralogy of Fallot.

METHODS

From April 2002 to June 2013, 218 patients with repaired tetralogy of Fallot underwent magnetic resonance imaging; 165 (76%) underwent transannular repair and 36 (17%) underwent nontransannular repair. Linear regression analyses were used to identify the predictors for RV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), and ejection fraction.

RESULTS

On univariable analysis, male sex, ventricular septal defect (VSD) closure through the right ventricle, larger pulmonary artery index, and greater PR fraction were associated with greater RV volume indexes. Multivariable analyses identified male sex (β = 17.55, P < .001 for RV EDVI; β = 14.08, P = .001 for RV ESVI), VSD closure through RV (β = 8.49, P = .048 for RV ESVI), longer interval since repair (β = 1.29, P = .014 for RV EDVI), and greater PR fraction (β = 1.92, P < .001 for RV EDVI; β = 1.38, P < .001 for RV ESVI) as independent predictors for greater RV volume indexes. On univariable analysis, male sex, VSD closure through the right ventricle, and greater PR fraction were associated with a lower RV ejection fraction. Multivariable analysis identified male sex (β = -3.10, P = .018), VSD closure through the right ventricle (β = -3.05, P = .020), and greater PR fraction (β = -0.27, P < .001) as independent predictors for a lower RV ejection fraction.

CONCLUSIONS

Male sex, VSD closure through the right ventricle, longer interval since repair, and greater PR fraction were independent predictors of RV dilatation after tetralogy of Fallot repair. Male sex, VSD closure through the right ventricle, and greater PR fraction were also independent predictors of RV dysfunction.

Authors+Show Affiliations

Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea. Electronic address: tscheul@hanmail.net.Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.Department of Pediatric Cardiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.Department of Pediatric Cardiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.Department of Pediatric Cardiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.Department of Pediatric Cardiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.Department of Pediatric Cardiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.Department of Radiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25173118

Citation

Lee, Cheul, et al. "Factors Associated With Right Ventricular Dilatation and Dysfunction in Patients With Chronic Pulmonary Regurgitation After Repair of Tetralogy of Fallot: Analysis of Magnetic Resonance Imaging Data From 218 Patients." The Journal of Thoracic and Cardiovascular Surgery, vol. 148, no. 6, 2014, pp. 2589-95.
Lee C, Lee CH, Kwak JG, et al. Factors associated with right ventricular dilatation and dysfunction in patients with chronic pulmonary regurgitation after repair of tetralogy of Fallot: analysis of magnetic resonance imaging data from 218 patients. J Thorac Cardiovasc Surg. 2014;148(6):2589-95.
Lee, C., Lee, C. H., Kwak, J. G., Kim, S. H., Shim, W. S., Lee, S. Y., Jang, S. I., Park, S. J., & Kim, Y. M. (2014). Factors associated with right ventricular dilatation and dysfunction in patients with chronic pulmonary regurgitation after repair of tetralogy of Fallot: analysis of magnetic resonance imaging data from 218 patients. The Journal of Thoracic and Cardiovascular Surgery, 148(6), 2589-95. https://doi.org/10.1016/j.jtcvs.2014.07.051
Lee C, et al. Factors Associated With Right Ventricular Dilatation and Dysfunction in Patients With Chronic Pulmonary Regurgitation After Repair of Tetralogy of Fallot: Analysis of Magnetic Resonance Imaging Data From 218 Patients. J Thorac Cardiovasc Surg. 2014;148(6):2589-95. PubMed PMID: 25173118.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with right ventricular dilatation and dysfunction in patients with chronic pulmonary regurgitation after repair of tetralogy of Fallot: analysis of magnetic resonance imaging data from 218 patients. AU - Lee,Cheul, AU - Lee,Chang-Ha, AU - Kwak,Jae Gun, AU - Kim,Seong-Ho, AU - Shim,Woo-Sup, AU - Lee,Sang Yun, AU - Jang,So-Ick, AU - Park,Su-Jin, AU - Kim,Yang Min, Y1 - 2014/08/01/ PY - 2014/04/09/received PY - 2014/07/09/revised PY - 2014/07/14/accepted PY - 2014/9/1/entrez PY - 2014/9/1/pubmed PY - 2015/1/24/medline SP - 2589 EP - 95 JF - The Journal of thoracic and cardiovascular surgery JO - J. Thorac. Cardiovasc. Surg. VL - 148 IS - 6 N2 - OBJECTIVE: The aim of the present study was to identify the factors associated with right ventricular (RV) dilatation and dysfunction in patients with chronic pulmonary regurgitation (PR) after repair of tetralogy of Fallot. METHODS: From April 2002 to June 2013, 218 patients with repaired tetralogy of Fallot underwent magnetic resonance imaging; 165 (76%) underwent transannular repair and 36 (17%) underwent nontransannular repair. Linear regression analyses were used to identify the predictors for RV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), and ejection fraction. RESULTS: On univariable analysis, male sex, ventricular septal defect (VSD) closure through the right ventricle, larger pulmonary artery index, and greater PR fraction were associated with greater RV volume indexes. Multivariable analyses identified male sex (β = 17.55, P < .001 for RV EDVI; β = 14.08, P = .001 for RV ESVI), VSD closure through RV (β = 8.49, P = .048 for RV ESVI), longer interval since repair (β = 1.29, P = .014 for RV EDVI), and greater PR fraction (β = 1.92, P < .001 for RV EDVI; β = 1.38, P < .001 for RV ESVI) as independent predictors for greater RV volume indexes. On univariable analysis, male sex, VSD closure through the right ventricle, and greater PR fraction were associated with a lower RV ejection fraction. Multivariable analysis identified male sex (β = -3.10, P = .018), VSD closure through the right ventricle (β = -3.05, P = .020), and greater PR fraction (β = -0.27, P < .001) as independent predictors for a lower RV ejection fraction. CONCLUSIONS: Male sex, VSD closure through the right ventricle, longer interval since repair, and greater PR fraction were independent predictors of RV dilatation after tetralogy of Fallot repair. Male sex, VSD closure through the right ventricle, and greater PR fraction were also independent predictors of RV dysfunction. SN - 1097-685X UR - https://www.unboundmedicine.com/medline/citation/25173118/Factors_associated_with_right_ventricular_dilatation_and_dysfunction_in_patients_with_chronic_pulmonary_regurgitation_after_repair_of_tetralogy_of_Fallot:_analysis_of_magnetic_resonance_imaging_data_from_218_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5223(14)01023-X DB - PRIME DP - Unbound Medicine ER -