Abstract 1622: Effect of the Obesity Epidemic on Ventricular Performance in Patients After Tetralogy of Fallot Repair: Evaluation by Cardiac Magnetic Resonance
Background: Obesity is an epidemic & is one of the few modifiable risk factors in congenital heart disease; it imposes a burden on an already compromised heart. The rate of obesity in normal children is ~ 16%.
Methods: Utilizing cardiac magnetic resonance (CMR) we studied the effect of obesity on right (RV) and left ventricular (LV) performance in pts after tetralogy of Fallot (TOF) repair. No pts had evidence of residual VSD, RV outflow tract obstruction pulmonary stenosis or pericardial effusion.
Results: Between January 2005 and January 2007, 88 TOF pts were studied. Of those, 13 (15%) were found to be obese with body mass index (BMI) > 95% for age; 75 had a normal BMI. RV and LV performance is listed in the table⇓ as mean±standard deviation. Mass was indexed to the height2.7 (ht2.7) and ventricular volumes were indexed to body surface area (BSA). Both RV and LV mass were increased in the obese TOF group compared with the non-obese TOF pts. The RV mass was more affected than the LV mass with increases of 68 and 48% respectively. The pulmonary regurgitant fraction (RF) of both groups were comparable.
Conclusion: The obesity rate is similar between TOF pts and normal children. In addition, biventricular mass is increased in obese pts with TOF with RV mass being more profoundly affected. Other markers of ventricular performance as measured by CMR are no different compared to normal weight subjects. Increased ventricular mass may have a negative impact on long-term outcome in pts with TOF.