PMID- 37710173 OWN - NLM STAT- MEDLINE DCOM- 20230918 LR - 20231120 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 23 IP - 1 DP - 2023 Sep 14 TI - Right ventricular dilatation score: a new assessment to right ventricular dilatation in adult patients with repaired tetralogy of Fallot. PG - 458 LID - 10.1186/s12872-023-03487-2 [doi] LID - 458 AB - BACKGROUND: Patients with repaired tetralogy of Fallot (rTOF) experience long-term chronic pulmonary valve regurgitation resulting in right ventricular (RV) dilatation. According to current guidelines, the evaluation of patients with rTOF for RV dilatation should be based on cardiac magnetic resonance (CMR). However, for many asymptomatic patients, routine CMR is not practical. Our study aims to identify screening methods for CMR based on echocardiographic data, with the goal of establishing a more practical and cheap method of screening for severity of RV dilatation in patients with asymptomatic rTOF. METHODS: Thirty two rTOF patients (mean age, 21(10.5) y, 21 males) with moderate to severe pulmonary regurgitation (PR) were prospectively recruited. Each patient received CMR and echocardiogram examination within 1 month prior to operation and collected clinical data, and then received echocardiogram examination at discharge and 3-6 months post-surgery. RESULTS: RV moderate-severe dilatation was defined as right ventricular end-diastolic volume index (RVEDVI) >/= 160 ml/m2 or right ventricular end-systolic volume index (RVESVI) >/= 80 ml/m2 in 15 of 32 patients (RVEDVI, 202.15[171.51, 252.56] ml/m2, RVESVI, 111.99 [96.28, 171.74] ml/m2). The other 17 (RVESDI, 130.19 [117.91, 139.35] ml/m2, RVESVI = 67.91 [63.35, 73.11] ml/m2) were defined as right ventricle mild dilatation, i.e., RVEDVI < 160 ml/m2 and RVESVI < 80 ml/m2, and the two parameters were higher than normal values. Compared with the RV mild dilatation group, patients of RV moderate-severe dilatation have worse cardiac function before surgery (right ventricular ejection fraction, 38.92(9.19) % versus 48.31(5.53) %, p < 0.001; Left ventricular ejection fraction, 59.80(10.26) versus 66.41(4.15), p = 0.021). Patients with RV moderate-severe dilatation faced longer operation time and more blood transfusion during operation (operation time, 271.53(08.33) min versus 170.53(72.36) min, p < 0.01; Intraoperative blood transfusion, 200(175) ml versus 100(50) ml, p = 0.001). Postoperative RV moderate-severe dilatation patients have poor short-term prognosis, which was reflected in a longer postoperative hospital stay (6.59 [2.12] days versus 9.80 [5.10] days, p = 0.024) and a higher incidence of hypohepatia (0[0] % versus 4[26.7] %, p = 0.023). Patients with RV dilatation score > 2.35 were diagnosed with RV moderate-severe dilatation (AUC = 0,882; Sensitivity = 94.1%; Specificity = 77.3%). CONCLUSIONS: RV moderate-severe dilatation is associated with worse preoperative cardiac function and short-term prognosis after PVR in rTOF patients with moderate to severe PR. The RV dilatation score is an effective screening method. When RV dilatation score > 2.35, the patient is indicated for further CMR examination and treatment. CI - (c) 2023. BioMed Central Ltd., part of Springer Nature. FAU - Zhou, Ziqin AU - Zhou Z AD - Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China. FAU - Huang, Ying AU - Huang Y AD - Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China. FAU - Han, Linjiang AU - Han L AD - Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China. FAU - Zhang, Yong AU - Zhang Y AD - Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China. FAU - Zhao, Junfei AU - Zhao J AD - Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China. FAU - Wen, Shusheng AU - Wen S AD - Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China. FAU - Chen, Jimei AU - Chen J AD - Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China. jimei_1965@outlook.com. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230914 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Male MH - Humans MH - Adult MH - Young Adult MH - *Tetralogy of Fallot/complications/diagnostic imaging/surgery MH - Stroke Volume MH - Dilatation MH - Ventricular Function, Left MH - Ventricular Function, Right MH - *Heart Defects, Congenital MH - *Pulmonary Valve Insufficiency/diagnostic imaging/etiology/surgery PMC - PMC10500856 OTO - NOTNLM OT - Cardiac magnetic resonance OT - Echocardiography OT - Pulmonary valve replacement OT - Right ventricular dilatation OT - Tetralogy of fallot COIS- The authors declare no competing interests. EDAT- 2023/09/15 00:42 MHDA- 2023/09/18 12:43 PMCR- 2023/09/14 CRDT- 2023/09/14 23:40 PHST- 2023/06/04 00:00 [received] PHST- 2023/08/31 00:00 [accepted] PHST- 2023/09/18 12:43 [medline] PHST- 2023/09/15 00:42 [pubmed] PHST- 2023/09/14 23:40 [entrez] PHST- 2023/09/14 00:00 [pmc-release] AID - 10.1186/s12872-023-03487-2 [pii] AID - 3487 [pii] AID - 10.1186/s12872-023-03487-2 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2023 Sep 14;23(1):458. doi: 10.1186/s12872-023-03487-2.