Patient-specific changes in rv function by CMRI in Tetralogy of Fallot patients prior to pulmonary valve replacement
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BioMed Central
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Poster presentation
Patient-specific changes in rv function by CMRI in Tetralogy of Fallot patients prior to pulmonary valve replacement Rina Gandhi*1, Marijn Brummer1, Sajid Siddiq1, Charles Kitchen1, Carey Lamphier2 and James Parks2 Address: 1Emory University, Atlanta, GA, USA and 2Children's Healthcare of Atlanta, Atlanta, GA, USA * Corresponding author
from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010 Published: 21 January 2010 Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P26
doi:10.1186/1532-429X-12-S1-P26
Abstracts of the 13th Annual SCMR Scientific Sessions - 2010
Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-infoThis abstract is available from: http://jcmr-online.com/content/12/S1/P26 © 2010 Gandhi et al; licensee BioMed Central Ltd.
Introduction
Results
Survival rates for children with tetralogy of Fallot (TOF) following initial repair are excellent but susceptible to varying long-term outcome. Current management uses clinical and imaging parameters to determine need and timing for pulmonary valve replacement (PVR) surgery. At present, no consensus exists on the preferred protocol or best criteria. Clinical imaging studies, in the TOF population, have shown deterioration in ventricular function prior to surgery and improvement following surgery. However, few serial imaging studies prior to PVR have been published to date. In this IRB approved study, we investigated progression of ventricular function parameters in 31 children with TOF, who underwent serial (two or more) MRI studies.
Review of the serial studies showed (mean value) decline in cardiac function in most parameters in a direction consistent with known disease progression patterns in TOF. However, changes are not significantly different from zero for all parameters in these patients and measurements. We observed significant change in RVESV (p = 0.045), RVEDV (p = .003), RVSV (p = .017), and a PR (p = .016). Table 1 shows changes per year in all observed ventricular function parameters. Figure 1 shows a histogram of the
Methods We examined 31 patients (16 M, 15 F) in serial MRI studies post repair and prior to PVR. The patients at time of initial MRI were 2 to 21 years of age (mean 11) and 0.6 to 5.4 years (mean 3) between the first and last MRI scan. The following cardiac function parameters were evaluated for both ventricles: ejection fraction (EF), cardiac output (CO), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and pulmonary regurgitation (PR). All values except EF were normalized to body surface area. The interval change amount was normalized by the time between studies to show change per year.
Figure 1forof Histogram RVEDV the the 31distribution patients of the changes (per year) in Histogram of the distribution of the changes (per year) in RVEDV for the 31 patients.
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