PMID- 31578553
OWN - NLM
STAT- MEDLINE
DCOM- 20210625
LR  - 20210625
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Linking)
VI  - 21
IP  - 8
DP  - 2020 Aug 1
TI  - Right ventricular systolic dysfunction but not dilatation correlates with 
      prognostically significant reductions in exercise capacity in repaired Tetralogy 
      of Fallot.
PG  - 906-913
LID - 10.1093/ehjci/jez245 [doi]
AB  - AIMS: The optimal timing for pulmonary valve replacement in asymptomatic patients 
      with repaired Tetralogy of Fallot (rTOF) and pulmonary regurgitation remains 
      uncertain but is often guided by increases in right ventricular (RV) 
      end-diastolic volume. As cardiopulmonary exercise testing (CPET) performance is a 
      strong prognostic indicator, we assessed which cardiovascular magnetic resonance 
      (CMR) parameters correlate with reductions in exercise capacity to potentially 
      improve identification of high-risk patients. METHODS AND RESULTS: In all, 163 
      patients with rTOF (mean age 24.5 +/- 10.2 years) who had previously undergone CMR 
      and standardized CPET protocols were included. The indexed right and left 
      ventricular end-diastolic volumes (RVEDVi, LVEDVi), right and left ventricular 
      ejection fractions (RVEF, LVEF), indexed RV stroke volume (RVSVi), and pulmonary 
      regurgitant fraction (PRF) were quantified by CMR and correlated with 
      CPET-determined peak oxygen consumption (VO2) or peak work. On univariable 
      analysis, there was no significant correlation between RVEDVi and PRF with peak 
      VO2 or peak work (% Jones-predicted). In contrast, RVEF and RVSVi had significant 
      correlations with both peak VO2 and peak work that remained significant on 
      multivariable analysis. For a previously established prognostic peak VO2 
      threshold of <27 mL/kg/min, receiver-operating characteristic curve analysis 
      demonstrated a Harrell's c of 0.70 for RVEF (95% confidence interval 0.61-0.79) 
      with a sensitivity of 88% for RVEF <40%. CONCLUSION: In rTOF, CMR indices of RV 
      systolic function are better predictors of CPET performance than RV size. An RVEF 
      <40% may be useful to identify prognostically significant reductions in exercise 
      capacity in patients with varying degrees of RV dilatation.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.
FAU - Rashid, Imran
AU  - Rashid I
AD  - Cardiovascular Magnetic Resonance Sydney, 100 Carillon Ave, Newtown, NSW 2042, 
      Australia.
AD  - School of Biomedical Engineering and Imaging Sciences, King's College London, 
      Westminster Bridge Rd, Lambeth SE17EH, UK.
AD  - Department of Cardiology, Guy's and St Thomas' Hospital, Westminster Bridge Rd, 
      Lambeth SE17EH, UK.
FAU - Mahmood, Adil
AU  - Mahmood A
AD  - School of Biomedical Engineering and Imaging Sciences, King's College London, 
      Westminster Bridge Rd, Lambeth SE17EH, UK.
FAU - Ismail, Tevfik F
AU  - Ismail TF
AD  - School of Biomedical Engineering and Imaging Sciences, King's College London, 
      Westminster Bridge Rd, Lambeth SE17EH, UK.
AD  - Department of Cardiology, Guy's and St Thomas' Hospital, Westminster Bridge Rd, 
      Lambeth SE17EH, UK.
FAU - O'Meagher, Shamus
AU  - O'Meagher S
AD  - Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, 
      Australia.
AD  - Department of Cardiology, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, 
      Sydney, NSW 2050, Australia.
FAU - Kutty, Shelby
AU  - Kutty S
AD  - University of Nebraska Medical Center, Children's Hospital and Medical Center, 
      42nd and Emile, Omaha, NE 68198, USA.
FAU - Celermajer, David
AU  - Celermajer D
AD  - Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, 
      Australia.
AD  - Department of Cardiology, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, 
      Sydney, NSW 2050, Australia.
FAU - Puranik, Rajesh
AU  - Puranik R
AD  - Cardiovascular Magnetic Resonance Sydney, 100 Carillon Ave, Newtown, NSW 2042, 
      Australia.
AD  - Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, 
      Australia.
AD  - Department of Cardiology, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, 
      Sydney, NSW 2050, Australia.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Dilatation
MH  - Exercise Tolerance
MH  - Humans
MH  - *Pulmonary Valve Insufficiency/diagnostic imaging/surgery
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - *Tetralogy of Fallot/diagnostic imaging/surgery
MH  - *Ventricular Dysfunction, Right/diagnostic imaging
MH  - Ventricular Function, Right
MH  - Young Adult
OTO - NOTNLM
OT  - Tetralogy of Fallot
OT  - cardiopulmonary exercise testing
OT  - cardiovascular magnetic resonance
OT  - ventricular function
EDAT- 2019/10/04 06:00
MHDA- 2021/06/29 06:00
CRDT- 2019/10/04 06:00
PHST- 2019/02/15 00:00 [received]
PHST- 2019/07/28 00:00 [revised]
PHST- 2019/09/11 00:00 [accepted]
PHST- 2019/10/04 06:00 [pubmed]
PHST- 2021/06/29 06:00 [medline]
PHST- 2019/10/04 06:00 [entrez]
AID - 5580337 [pii]
AID - 10.1093/ehjci/jez245 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2020 Aug 1;21(8):906-913. doi: 
      10.1093/ehjci/jez245.