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Left and right ventricular dyssynchrony and strains from cardiovascular magnetic resonance feature tracking do not predict deterioration of ventricular function in patients with repaired tetralogy of Fallot.
J Cardiovasc Magn Reson. 2016 08 22; 18(1):49.JC

Abstract

BACKGROUND

Patients with repaired tetralogy of Fallot (rTOF) suffer from progressive ventricular dysfunction decades after their surgical repair. We hypothesized that measures of ventricular strain and dyssynchrony would predict deterioration of ventricular function in patients with rTOF.

METHODS

A database search identified all patients at a single institution with rTOF who underwent cardiovascular magnetic resonance (CMR) at least twice, >6 months apart, without intervening surgical or catheter procedures. Seven primary predictors were derived from the first CMR using a custom feature tracking algorithm: left (LV), right (RV) and inter-ventricular dyssynchrony, LV and RV peak global circumferential strains, and LV and RV peak global longitudinal strains. Three outcomes were defined, whose changes were assessed over time: RV end-diastolic volume, and RV and LV ejection fraction. Multivariate linear mixed models were fit to investigate relationships of outcomes to predictors and ten potential baseline confounders.

RESULTS

One hundred fifty-three patients with rTOF (23 ± 14 years, 50 % male) were included. The mean follow-up duration between the first and last CMR was 2.9 ± 1.3 years. After adjustment for confounders, none of the 7 primary predictors were significantly associated with change over time in the 3 outcome variables. Only 1-17 % of the variability in the change over time in the outcome variables was explained by the baseline predictors and potential confounders.

CONCLUSIONS

In patients with repaired tetralogy of Fallot, ventricular dyssynchrony and global strain derived from cine CMR were not significantly related to changes in ventricular size and function over time. The ability to predict deterioration in ventricular function in patients with rTOF using current methods is limited.

Authors+Show Affiliations

Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA. Institute for Advanced Application, Geisinger Health System, 100 North Academy Avenue, Danville, PA, 17822-4400, USA.Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA.Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA. Institute for Advanced Application, Geisinger Health System, 100 North Academy Avenue, Danville, PA, 17822-4400, USA.Department of Biostatistics, University of Kentucky, Lexington, KY, USA.Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA.Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA.Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA.Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA. Institute for Advanced Application, Geisinger Health System, 100 North Academy Avenue, Danville, PA, 17822-4400, USA.Department of Cardiology, Boston Children's Hospital, Boston, MA, USA. Department of Pediatrics, Harvard Medical School, Boston, MA, USA.Department of Cardiology, Boston Children's Hospital, Boston, MA, USA. Department of Pediatrics, Harvard Medical School, Boston, MA, USA.Department of Cardiology, Boston Children's Hospital, Boston, MA, USA. Department of Pediatrics, Harvard Medical School, Boston, MA, USA.Department of Cardiology, Boston Children's Hospital, Boston, MA, USA. Department of Pediatrics, Harvard Medical School, Boston, MA, USA.Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA. bkf@gatech.edu. Institute for Advanced Application, Geisinger Health System, 100 North Academy Avenue, Danville, PA, 17822-4400, USA. bkf@gatech.edu.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

27549809

Citation

Jing, Linyuan, et al. "Left and Right Ventricular Dyssynchrony and Strains From Cardiovascular Magnetic Resonance Feature Tracking Do Not Predict Deterioration of Ventricular Function in Patients With Repaired Tetralogy of Fallot." Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance, vol. 18, no. 1, 2016, p. 49.
Jing L, Wehner GJ, Suever JD, et al. Left and right ventricular dyssynchrony and strains from cardiovascular magnetic resonance feature tracking do not predict deterioration of ventricular function in patients with repaired tetralogy of Fallot. J Cardiovasc Magn Reson. 2016;18(1):49.
Jing, L., Wehner, G. J., Suever, J. D., Charnigo, R. J., Alhadad, S., Stearns, E., Mojsejenko, D., Haggerty, C. M., Hickey, K., Valente, A. M., Geva, T., Powell, A. J., & Fornwalt, B. K. (2016). Left and right ventricular dyssynchrony and strains from cardiovascular magnetic resonance feature tracking do not predict deterioration of ventricular function in patients with repaired tetralogy of Fallot. Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance, 18(1), 49. https://doi.org/10.1186/s12968-016-0268-8
Jing L, et al. Left and Right Ventricular Dyssynchrony and Strains From Cardiovascular Magnetic Resonance Feature Tracking Do Not Predict Deterioration of Ventricular Function in Patients With Repaired Tetralogy of Fallot. J Cardiovasc Magn Reson. 2016 08 22;18(1):49. PubMed PMID: 27549809.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Left and right ventricular dyssynchrony and strains from cardiovascular magnetic resonance feature tracking do not predict deterioration of ventricular function in patients with repaired tetralogy of Fallot. AU - Jing,Linyuan, AU - Wehner,Gregory J, AU - Suever,Jonathan D, AU - Charnigo,Richard J, AU - Alhadad,Sudad, AU - Stearns,Evan, AU - Mojsejenko,Dimitri, AU - Haggerty,Christopher M, AU - Hickey,Kelsey, AU - Valente,Anne Marie, AU - Geva,Tal, AU - Powell,Andrew J, AU - Fornwalt,Brandon K, Y1 - 2016/08/22/ PY - 2016/06/02/received PY - 2016/07/22/accepted PY - 2016/8/24/entrez PY - 2016/8/24/pubmed PY - 2017/12/13/medline KW - Cardiac strain KW - Cardiovascular magnetic resonance KW - Congenital heart disease KW - Dyssynchrony KW - Tetralogy of Fallot SP - 49 EP - 49 JF - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance JO - J Cardiovasc Magn Reson VL - 18 IS - 1 N2 - BACKGROUND: Patients with repaired tetralogy of Fallot (rTOF) suffer from progressive ventricular dysfunction decades after their surgical repair. We hypothesized that measures of ventricular strain and dyssynchrony would predict deterioration of ventricular function in patients with rTOF. METHODS: A database search identified all patients at a single institution with rTOF who underwent cardiovascular magnetic resonance (CMR) at least twice, >6 months apart, without intervening surgical or catheter procedures. Seven primary predictors were derived from the first CMR using a custom feature tracking algorithm: left (LV), right (RV) and inter-ventricular dyssynchrony, LV and RV peak global circumferential strains, and LV and RV peak global longitudinal strains. Three outcomes were defined, whose changes were assessed over time: RV end-diastolic volume, and RV and LV ejection fraction. Multivariate linear mixed models were fit to investigate relationships of outcomes to predictors and ten potential baseline confounders. RESULTS: One hundred fifty-three patients with rTOF (23 ± 14 years, 50 % male) were included. The mean follow-up duration between the first and last CMR was 2.9 ± 1.3 years. After adjustment for confounders, none of the 7 primary predictors were significantly associated with change over time in the 3 outcome variables. Only 1-17 % of the variability in the change over time in the outcome variables was explained by the baseline predictors and potential confounders. CONCLUSIONS: In patients with repaired tetralogy of Fallot, ventricular dyssynchrony and global strain derived from cine CMR were not significantly related to changes in ventricular size and function over time. The ability to predict deterioration in ventricular function in patients with rTOF using current methods is limited. SN - 1532-429X UR - https://www.unboundmedicine.com/medline/citation/27549809/Left_and_right_ventricular_dyssynchrony_and_strains_from_cardiovascular_magnetic_resonance_feature_tracking_do_not_predict_deterioration_of_ventricular_function_in_patients_with_repaired_tetralogy_of_Fallot_ L2 - https://jcmr-online.biomedcentral.com/articles/10.1186/s12968-016-0268-8 DB - PRIME DP - Unbound Medicine ER -