Abstract 12028: Left Ventricular Contractile Reserve Assessed by Exercise Stress Echocardiogram in Adults With Repaired Tetralogy of Fallot: A Novel Early Marker of Intrinsic Myocardial Disease?
Background and objective: Left (LV) and right (RV) ventricular systolic dysfunction have been identified as risk factors for adverse outcomes in patients with repaired Tetralogy of Fallot (TOF) and early detection is mandatory. Using exercice stress echocardiography (ESE), this study investigated LV contractile reserve in TOF patients compared with healthy adults.
Methods: 28 adults with repaired TOF and 28 age- and sex- matched controls were propectively evaluated with supine bicycle ESE. Contractile reserve was evaluated by mesuring LV stroke volume at rest and on exertion.
Results: TOF patients (age, 35±10 years; male, 14) had a smaller increase in LV stroke volume on maximal exertion than controls, even when corrected for maximum workload performed (12±16% vs 28±16%, p=0,015) (Figure 1). No correlation was found between exercice stroke volume and degree of pulmonary insufficiency or RV and LV size and function at rest.
Conclusions: LV contractile reserve is impaired in patients with repaired TOF, independently of their degree of pulmonary insufficiency or RV and LV size and function. Importantly, these findings may suggest an intrinsic LV myocardial abnormality in TOF patients, for which early detection may be achieved by ESE. Larger studies are needed to determine if impaired contractile reserve represents an independent risk factor for ventricular tachycardia and or death in these patients.
Author Disclosures: A. Michaud: None. P. Gilbert: None. M.A. Gatzoulis: None. P. Pibarot: None. J. Rodés-Cabau: None. J. Perron: None. E. Bedard: None.
- © 2014 by American Heart Association, Inc.