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CMR feature tracking left ventricular strain-rate predicts ventricular tachyarrhythmia, but not deterioration of ventricular function in patients with repaired tetralogy of Fallot.
Int J Cardiol. 2019 11 15; 295:1-6.IJ

Abstract

BACKGROUND

Myocardial strain has been shown to predict outcome in various cardiovascular diseases, including congenital heart diseases. The aim of this study was to evaluate the predictive value of cardiac magnetic resonance (CMR) feature-tracking derived strain parameters in repaired tetralogy of Fallot (rTOF) patients for developing ventricular tachycardia (VT) and deterioration of ventricular function.

METHODS

Patients with rTOF who underwent CMR investigation were included. Strain and strain-rate of both ventricles were assessed using CMR feature tracking. The primary outcome was a composite of the occurrence of sustained VT or non-sustained VT requiring invasive therapy. The secondary outcome was analyzed in patients that underwent a second CMR after 1.5 to 3.5 years. Deterioration was defined as reduction (≥10%) in right ventricular (RV) ejection fraction, reduction (≥10%) in left ventricular (LV) ejection fraction or increase (≥30 mL/m2) in indexed RV end-diastolic volume compared to baseline.

RESULTS

172 patients (median age 24.3 years, 54 patients <18 years) were included. Throughout a median follow-up of 7.4 years, 9 patients (4.5%) experienced the primary endpoint of VT. Multivariate Cox-regression analysis showed that LV systolic circumferential strain-rate was independently predictive of primary outcome (p = 0.023). 70 patients underwent a serial CMR, of whom 14 patients (20%) showed ventricular deterioration. Logistic regression showed no predictive value of strain and strain-rate parameters.

CONCLUSIONS

In patients with rTOF, LV systolic circumferential strain-rate is an independent predictor for the development of VT. Ventricular strain parameters did not predict deterioration of ventricular function in the studied population.

Authors+Show Affiliations

Center for Congenital Heart Diseases, Department of Pediatric Cardiology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: q.a.j.hagdorn@umcg.nl.Center for Congenital Heart Diseases, Department of Pediatric Cardiology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: n.e.beurskens@amc.uva.nl.Center for Congenital Heart Diseases, Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: tm.gorter@umcg.nl.Center for Congenital Heart Diseases, Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: s.l.meyer@umcg.nl.Center for Congenital Heart Diseases, Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: j.p.van.melle@umcg.nl.Center for Congenital Heart Diseases, Department of Pediatric Cardiology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: r.m.f.berger@umcg.nl.Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: t.p.willems@umcg.nl.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31402156

Citation

Hagdorn, Quint A J., et al. "CMR Feature Tracking Left Ventricular Strain-rate Predicts Ventricular Tachyarrhythmia, but Not Deterioration of Ventricular Function in Patients With Repaired Tetralogy of Fallot." International Journal of Cardiology, vol. 295, 2019, pp. 1-6.
Hagdorn QAJ, Vos JDL, Beurskens NEG, et al. CMR feature tracking left ventricular strain-rate predicts ventricular tachyarrhythmia, but not deterioration of ventricular function in patients with repaired tetralogy of Fallot. Int J Cardiol. 2019;295:1-6.
Hagdorn, Q. A. J., Vos, J. D. L., Beurskens, N. E. G., Gorter, T. M., Meyer, S. L., van Melle, J. P., Berger, R. M. F., & Willems, T. P. (2019). CMR feature tracking left ventricular strain-rate predicts ventricular tachyarrhythmia, but not deterioration of ventricular function in patients with repaired tetralogy of Fallot. International Journal of Cardiology, 295, 1-6. https://doi.org/10.1016/j.ijcard.2019.07.097
Hagdorn QAJ, et al. CMR Feature Tracking Left Ventricular Strain-rate Predicts Ventricular Tachyarrhythmia, but Not Deterioration of Ventricular Function in Patients With Repaired Tetralogy of Fallot. Int J Cardiol. 2019 11 15;295:1-6. PubMed PMID: 31402156.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CMR feature tracking left ventricular strain-rate predicts ventricular tachyarrhythmia, but not deterioration of ventricular function in patients with repaired tetralogy of Fallot. AU - Hagdorn,Quint A J, AU - Vos,Johan D L, AU - Beurskens,Niek E G, AU - Gorter,Thomas M, AU - Meyer,Sophie L, AU - van Melle,Joost P, AU - Berger,Rolf M F, AU - Willems,Tineke P, Y1 - 2019/08/01/ PY - 2019/02/19/received PY - 2019/07/29/revised PY - 2019/07/31/accepted PY - 2019/8/14/pubmed PY - 2020/7/10/medline PY - 2019/8/13/entrez KW - Cardiac magnetic resonance KW - Congenital heart disease KW - Deformation KW - Strain KW - Tetralogy of Fallot KW - Ventricular tachycardia SP - 1 EP - 6 JF - International journal of cardiology JO - Int J Cardiol VL - 295 N2 - BACKGROUND: Myocardial strain has been shown to predict outcome in various cardiovascular diseases, including congenital heart diseases. The aim of this study was to evaluate the predictive value of cardiac magnetic resonance (CMR) feature-tracking derived strain parameters in repaired tetralogy of Fallot (rTOF) patients for developing ventricular tachycardia (VT) and deterioration of ventricular function. METHODS: Patients with rTOF who underwent CMR investigation were included. Strain and strain-rate of both ventricles were assessed using CMR feature tracking. The primary outcome was a composite of the occurrence of sustained VT or non-sustained VT requiring invasive therapy. The secondary outcome was analyzed in patients that underwent a second CMR after 1.5 to 3.5 years. Deterioration was defined as reduction (≥10%) in right ventricular (RV) ejection fraction, reduction (≥10%) in left ventricular (LV) ejection fraction or increase (≥30 mL/m2) in indexed RV end-diastolic volume compared to baseline. RESULTS: 172 patients (median age 24.3 years, 54 patients <18 years) were included. Throughout a median follow-up of 7.4 years, 9 patients (4.5%) experienced the primary endpoint of VT. Multivariate Cox-regression analysis showed that LV systolic circumferential strain-rate was independently predictive of primary outcome (p = 0.023). 70 patients underwent a serial CMR, of whom 14 patients (20%) showed ventricular deterioration. Logistic regression showed no predictive value of strain and strain-rate parameters. CONCLUSIONS: In patients with rTOF, LV systolic circumferential strain-rate is an independent predictor for the development of VT. Ventricular strain parameters did not predict deterioration of ventricular function in the studied population. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/31402156/CMR_feature_tracking_left_ventricular_strain_rate_predicts_ventricular_tachyarrhythmia_but_not_deterioration_of_ventricular_function_in_patients_with_repaired_tetralogy_of_Fallot_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(19)30911-8 DB - PRIME DP - Unbound Medicine ER -