Tags

Type your tag names separated by a space and hit enter

Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot.
J Cardiovasc Magn Reson. 2016 Oct 26; 18(1):75.JC

Abstract

BACKGROUND

Unfavorable left ventricular (LV) remodelling may be associated with adverse outcomes after Tetralogy of Fallot (TOF) repair. We sought to assess T1 cardiovascular magnetic resonance (CMR) markers of diffuse LV myocardial fibrosis in children after TOF repair, and associated factors.

METHODS

In this prospective, cross-sectional study, native (=non-contrast) T1 times and extracellular volume fraction (ECV) were quantified in the LV myocardium using CMR. Results were related to ventricular volumes and function, degree of pulmonary regurgitation, as well as surgical characteristics, and exercise capacity.

RESULTS

There was no difference in native T1 times or ECV between 31 TOF patients (age at CMR 13.9 ± 2.4 years, 19 male) and 15 controls (age at CMR 13.4 ± 2.6 years, 7 male). Female TOF patients had higher ECVs than males (25.2 ± 2.9 % versus 22.7 ± 3.3 %, p < 0.05). In the patient group, higher native T1 and ECV correlated with higher Z-Scores of right and left ventricular end-diastolic volumes, but not with reduced left and right ventricular ejection fraction or higher pulmonary regurgitation fraction. Longer cardiopulmonary bypass and aortic cross clamp times at surgery correlated with increased native T1 times and ECVs (r = 0.48, p < 0.05 and r = 0.65, p < 0.01, respectively). Maximum workload (percent of predicted for normal) correlated inversely with ECV (r = -0.62, p < 0.05). Higher native T1 times correlated with worse LV longitudinal (r = 0.50, p < 0.05) and mid short axis circumferential strain (r = 0.38, p < 0.05).

CONCLUSIONS

As compared to controls, TOF patients did not express higher markers of diffuse fibrosis. Longer cardiopulmonary bypass and aortic cross clamp times at surgery as well as biventricular enlargement and reduced exercise tolerance are associated with markers of diffuse myocardial fibrosis after TOF repair. Female patients have higher markers of diffuse myocardial fibrosis than males.

Authors+Show Affiliations

Department of Pediatrics, Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. JenRiesenkampff@gmx.net.Department of Pediatrics, Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.Department of Pediatrics, Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.Department of Pediatrics, Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.Department of Pediatrics, Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.Department of Pediatrics, Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.Department of Pediatrics, Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.Department of Pediatrics, Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.Department of Pediatrics, Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27782857

Citation

Riesenkampff, Eugénie, et al. "Increased Left Ventricular Myocardial Extracellular Volume Is Associated With Longer Cardiopulmonary Bypass Times, Biventricular Enlargement and Reduced Exercise Tolerance in Children After Repair of Tetralogy of Fallot." Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance, vol. 18, no. 1, 2016, p. 75.
Riesenkampff E, Luining W, Seed M, et al. Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot. J Cardiovasc Magn Reson. 2016;18(1):75.
Riesenkampff, E., Luining, W., Seed, M., Chungsomprasong, P., Manlhiot, C., Elders, B., McCrindle, B. W., Yoo, S. J., & Grosse-Wortmann, L. (2016). Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot. Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance, 18(1), 75.
Riesenkampff E, et al. Increased Left Ventricular Myocardial Extracellular Volume Is Associated With Longer Cardiopulmonary Bypass Times, Biventricular Enlargement and Reduced Exercise Tolerance in Children After Repair of Tetralogy of Fallot. J Cardiovasc Magn Reson. 2016 Oct 26;18(1):75. PubMed PMID: 27782857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot. AU - Riesenkampff,Eugénie, AU - Luining,Wietske, AU - Seed,Mike, AU - Chungsomprasong,Paweena, AU - Manlhiot,Cedric, AU - Elders,Bernadette, AU - McCrindle,Brian W, AU - Yoo,Shi-Joon, AU - Grosse-Wortmann,Lars, Y1 - 2016/10/26/ PY - 2016/04/19/received PY - 2016/10/01/accepted PY - 2016/10/27/pubmed PY - 2017/12/13/medline PY - 2016/10/27/entrez KW - Diffuse fibrosis KW - T1 mapping KW - Tetralogy of Fallot SP - 75 EP - 75 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: Unfavorable left ventricular (LV) remodelling may be associated with adverse outcomes after Tetralogy of Fallot (TOF) repair. We sought to assess T1 cardiovascular magnetic resonance (CMR) markers of diffuse LV myocardial fibrosis in children after TOF repair, and associated factors. METHODS: In this prospective, cross-sectional study, native (=non-contrast) T1 times and extracellular volume fraction (ECV) were quantified in the LV myocardium using CMR. Results were related to ventricular volumes and function, degree of pulmonary regurgitation, as well as surgical characteristics, and exercise capacity. RESULTS: There was no difference in native T1 times or ECV between 31 TOF patients (age at CMR 13.9 ± 2.4 years, 19 male) and 15 controls (age at CMR 13.4 ± 2.6 years, 7 male). Female TOF patients had higher ECVs than males (25.2 ± 2.9 % versus 22.7 ± 3.3 %, p < 0.05). In the patient group, higher native T1 and ECV correlated with higher Z-Scores of right and left ventricular end-diastolic volumes, but not with reduced left and right ventricular ejection fraction or higher pulmonary regurgitation fraction. Longer cardiopulmonary bypass and aortic cross clamp times at surgery correlated with increased native T1 times and ECVs (r = 0.48, p < 0.05 and r = 0.65, p < 0.01, respectively). Maximum workload (percent of predicted for normal) correlated inversely with ECV (r = -0.62, p < 0.05). Higher native T1 times correlated with worse LV longitudinal (r = 0.50, p < 0.05) and mid short axis circumferential strain (r = 0.38, p < 0.05). CONCLUSIONS: As compared to controls, TOF patients did not express higher markers of diffuse fibrosis. Longer cardiopulmonary bypass and aortic cross clamp times at surgery as well as biventricular enlargement and reduced exercise tolerance are associated with markers of diffuse myocardial fibrosis after TOF repair. Female patients have higher markers of diffuse myocardial fibrosis than males. SN - 1532-429X UR - https://www.unboundmedicine.com/medline/citation/27782857/Increased_left_ventricular_myocardial_extracellular_volume_is_associated_with_longer_cardiopulmonary_bypass_times_biventricular_enlargement_and_reduced_exercise_tolerance_in_children_after_repair_of_Tetralogy_of_Fallot_ L2 - https://jcmr-online.biomedcentral.com/articles/10.1186/s12968-016-0290-x DB - PRIME DP - Unbound Medicine ER -