Abstract 15414: Cardiac Dyssynchrony and Strain Do Not Predict Deterioration of Ventricular Function in Patients With Repaired Tetralogy of Fallot
Objectives: Patients with repaired tetralogy of Fallot (rTOF) suffer from progressive ventricular dysfunction decades after their initial surgical repair. This study sought to determine whether measures of ventricular strain and dyssynchrony could predict deterioration of ventricular function in patients with rTOF.
Methods: A database search identified all patients at a single institution with rTOF who underwent cardiac magnetic resonance (CMR) at least twice, greater than 6 months apart, without intervening surgical or catheter procedures. Five primary potential predictors were derived from the first CMR using a custom feature tracking algorithm: left (LV), right (RV) and inter-ventricular dyssynchrony, and LV and RV peak circumferential strains. Three outcomes were defined as measures of progression over time: RV end-diastolic volume, RV ejection fraction (EF), and LV EF. A multivariate linear mixed model, subject to backward elimination of extraneous terms, was fit to investigate relationships between predictors and outcomes. Ten potential confounders (see table footnote) measured at baseline were also included in the model.
Results: A cohort of 153 patients with rTOF (23±14 years, 50% male) were included. The mean time between the first and last CMR was 2.9±1.3 years. None of the 5 primary predictors were significantly associated with change over time in the 3 outcomes in the multivariate model, though RV circumferential strain was associated with RV EF at baseline (table). Only 1-16% of the variability in the change over time in the 3 outcomes could be explained by the predictors in the multivariate model.
Conclusions: In patients with rTOF, measures of ventricular dyssynchrony and strain were not significantly related to changes in ventricular size and function over time in a multivariate analysis. The ability to predict deterioration in ventricular function using all potential predictors is limited.
- Congenital heart disease
- Magnetic resonance imaging
- ventricular dyssynchrony and strain
- ventricular dysfunction
Author Disclosures: L. Jing: None. J.D. Suever: None. R.J. Charnigo: None. S. Alhadad: None. E. Stearns: None. D. Mojsejenko: None. C.M. Haggerty: None. K. Hickey: None. A.M. Valente: None. T. Geva: Consultant/Advisory Board; Modest; Medtronic. A.J. Powell: None. B.K. Fornwalt: None.
- © 2015 by American Heart Association, Inc.