High Variability of Right Ventricular Volumes and Function in Adults with Severe Pulmonary Regurgitation Late After Tetralogy of Fallot Repair.

Greutmann, Matthias; Ruperti, Javier; Schwitz, Fabienne; Haag, Nora; Santos Lopes, Bruno; Meier, Lukas; Babic, Daniela; Valsangiacomo Buechel, Emanuela; Kellenberger, Christian; Bonassin, Francesca; Attenhofer Jost, Christine; Schwerzmann, Markus; Wustmann, Kerstin; Tobler, Daniel (2022). High Variability of Right Ventricular Volumes and Function in Adults with Severe Pulmonary Regurgitation Late After Tetralogy of Fallot Repair. The American journal of cardiology, 166, pp. 88-96. Elsevier 10.1016/j.amjcard.2021.11.022

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Our aim was to assess changes of right ventricular end-diastolic volumes (RVEDVi) and right ventricular ejection fraction (RVEF) in asymptomatic adults with repaired tetralogy of Fallot, with native right ventricular outflow tract and severe pulmonary regurgitation by serial cardiac magnetic resonance imaging (CMR). The study included 23 asymptomatic adults who underwent ≥3 CMR studies (total of 88 CMR studies). We compared changes in RVEDVi and RVEF between first and last study (median follow-up: 8.8 years, interquartile range: 6.3 to 13.1 years) and between all study pairs. Variability of measurements between study pairs (65 consecutive and 139 nonconsecutive CMR study pairs) were assessed using Bland-Altman analysis and intraclass correlation coefficients. On average, there were no significant changes of RVEDVi or RVEF over the study period (change in RVEDVi: +0.4 ± 17.8 ml/m2, change in RVEF: -1.0 ± 5.5%). Assessment of variability of measurements between study pairs demonstrated no systematic change in RVEDVi and RVEF between study pairs with limits of agreement within the range of previously published studies (RVEDVi -29.1 to +27.2 ml/m2; RVEF -11.5% to 10.2%). High intraclass correlation coefficients for RVEDVi (0.943, 95% CI 0.906 to 0.965, p <0.001) and RVEF (0.815, 95% CI 0.697 to 0.887, p <0.0001) indicate high reliability of reported measurements. In conclusion, in asymptomatic adults with repaired tetralogy of Fallot with native right ventricular outflow tracts and severe pulmonary regurgitation, CMR measurements of RV volumes and RVEF remain stable during follow-up with variability between CMR studies in individual patients, as expected for interobserver and interstudy variability. Measurements derived from a single CMR study or changes occurring between 2 CMR studies should be used with caution for clinical decision-making.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Ruperti Repilado, Francisco Javier; Schwitz, Fabienne Muriel; Schwerzmann, Markus and Wustmann, Kerstin Brigitte

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1879-1913

Publisher:

Elsevier

Language:

English

Submitter:

Markus Schwerzmann

Date Deposited:

08 Feb 2022 15:20

Last Modified:

17 Feb 2022 00:14

Publisher DOI:

10.1016/j.amjcard.2021.11.022

PubMed ID:

34949470

BORIS DOI:

10.48350/164738

URI:

https://boris.unibe.ch/id/eprint/164738

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