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Biventricular dyssynchrony on cardiac magnetic resonance imaging and its correlation with myocardial deformation, ventricular function and objective exercise capacity in patients with repaired tetralogy of Fallot.
Int J Cardiol. 2018 08 01; 264:53-57.IJ

Abstract

BACKGROUND

Electrical dyssynchrony and prolonged QRS duration are common in patients with repaired tetralogy of Fallot (ToF). It has been linked to increased risk of sudden cardiac death and right ventricular (RV) dysfunction. We investigated myocardial dyssynchrony using cardiac magnetic resonance imaging (CMR) and feature tracking analysis (FT) in this setting and compared it to myocardial deformation, conventional parameters of ventricular dysfunction and clinical parameters.

METHODS AND RESULTS

Patients underwent standardized CMR investigations as part of a nationwide study. We prospectively assessed myocardial deformation and analysed regional wall motion abnormalities of the RV and the left ventricle (LV) using CMR-FT. The main measure of dyssynchrony was the maximal time difference (wall motion delay) of the regional strain as a parameter of mechanical biventricular dyssynchrony. In addition, clinical parameters and measures of cardiopulmonary exercise capacity were available. Overall 345 patients were included. Parameters of biventricular wall motion delay correlated significantly with global FT-strain parameters (p < 0.0001 for all imaging planes assessed). Furthermore, we found a significant correlation between circumferential RV motion delay and QRS duration (p = 0.006). Higher LV and RV wall motion delay parameters were also associated with lower peak oxygen consumption (p < 0.05) and a worse LV and RV ejection fraction (p < 0.02).

CONCLUSIONS

Assessment of mechanical dyssynchrony is feasible using CMR-FT in ToF patients. Parameters of mechanical dyssynchrony correlate with electrical dyssynchrony, biventricular function and objective exercise capacity in this setting. Due to the weak degree of correlation, however, the clinical significance of these findings remains to be clarified by further studies.

Authors+Show Affiliations

Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, UK.Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.Institute for Biometry and Medical Informatics, University of Magdeburg, Germany.Department of Heart-, Thoracic-, Transplantation- and Vascular Surgery, Hannover Medical School, Germany.Department of Pediatric Cardiology and Pediatric Intensive Care, Hannover Medical School, Germany.Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany. Electronic address: gerhard.diller@ukmuenster.de.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29673853

Citation

Kalaitzidis, Pantelis, et al. "Biventricular Dyssynchrony On Cardiac Magnetic Resonance Imaging and Its Correlation With Myocardial Deformation, Ventricular Function and Objective Exercise Capacity in Patients With Repaired Tetralogy of Fallot." International Journal of Cardiology, vol. 264, 2018, pp. 53-57.
Kalaitzidis P, Orwat S, Kempny A, et al. Biventricular dyssynchrony on cardiac magnetic resonance imaging and its correlation with myocardial deformation, ventricular function and objective exercise capacity in patients with repaired tetralogy of Fallot. Int J Cardiol. 2018;264:53-57.
Kalaitzidis, P., Orwat, S., Kempny, A., Robert, R., Peters, B., Sarikouch, S., Beerbaum, P., Baumgartner, H., & Diller, G. P. (2018). Biventricular dyssynchrony on cardiac magnetic resonance imaging and its correlation with myocardial deformation, ventricular function and objective exercise capacity in patients with repaired tetralogy of Fallot. International Journal of Cardiology, 264, 53-57. https://doi.org/10.1016/j.ijcard.2018.04.005
Kalaitzidis P, et al. Biventricular Dyssynchrony On Cardiac Magnetic Resonance Imaging and Its Correlation With Myocardial Deformation, Ventricular Function and Objective Exercise Capacity in Patients With Repaired Tetralogy of Fallot. Int J Cardiol. 2018 08 1;264:53-57. PubMed PMID: 29673853.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biventricular dyssynchrony on cardiac magnetic resonance imaging and its correlation with myocardial deformation, ventricular function and objective exercise capacity in patients with repaired tetralogy of Fallot. AU - Kalaitzidis,Pantelis, AU - Orwat,Stefan, AU - Kempny,Aleksander, AU - Robert,Radke, AU - Peters,Brigitte, AU - Sarikouch,Samir, AU - Beerbaum,Philipp, AU - Baumgartner,Helmut, AU - Diller,Gerhard-Paul, AU - ,, Y1 - 2018/04/12/ PY - 2017/10/09/received PY - 2018/03/09/revised PY - 2018/04/02/accepted PY - 2018/4/21/pubmed PY - 2019/1/10/medline PY - 2018/4/21/entrez KW - Dyssynchrony KW - Magnetic resonance imaging KW - Tetralogy of Fallot SP - 53 EP - 57 JF - International journal of cardiology JO - Int J Cardiol VL - 264 N2 - BACKGROUND: Electrical dyssynchrony and prolonged QRS duration are common in patients with repaired tetralogy of Fallot (ToF). It has been linked to increased risk of sudden cardiac death and right ventricular (RV) dysfunction. We investigated myocardial dyssynchrony using cardiac magnetic resonance imaging (CMR) and feature tracking analysis (FT) in this setting and compared it to myocardial deformation, conventional parameters of ventricular dysfunction and clinical parameters. METHODS AND RESULTS: Patients underwent standardized CMR investigations as part of a nationwide study. We prospectively assessed myocardial deformation and analysed regional wall motion abnormalities of the RV and the left ventricle (LV) using CMR-FT. The main measure of dyssynchrony was the maximal time difference (wall motion delay) of the regional strain as a parameter of mechanical biventricular dyssynchrony. In addition, clinical parameters and measures of cardiopulmonary exercise capacity were available. Overall 345 patients were included. Parameters of biventricular wall motion delay correlated significantly with global FT-strain parameters (p < 0.0001 for all imaging planes assessed). Furthermore, we found a significant correlation between circumferential RV motion delay and QRS duration (p = 0.006). Higher LV and RV wall motion delay parameters were also associated with lower peak oxygen consumption (p < 0.05) and a worse LV and RV ejection fraction (p < 0.02). CONCLUSIONS: Assessment of mechanical dyssynchrony is feasible using CMR-FT in ToF patients. Parameters of mechanical dyssynchrony correlate with electrical dyssynchrony, biventricular function and objective exercise capacity in this setting. Due to the weak degree of correlation, however, the clinical significance of these findings remains to be clarified by further studies. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/29673853/Biventricular_dyssynchrony_on_cardiac_magnetic_resonance_imaging_and_its_correlation_with_myocardial_deformation_ventricular_function_and_objective_exercise_capacity_in_patients_with_repaired_tetralogy_of_Fallot_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(17)36262-9 DB - PRIME DP - Unbound Medicine ER -