Papa, Andrea; Nussbaumer, Clément; Goulouti, Eleni; Schwitz, Fabienne; Wustmann, Kerstin; Tobler, Daniel; Greutmann, Matthias; Schwerzmann, Markus (2024). Prognostic value of right ventricular dyssynchrony in adults with repaired tetralogy of Fallot. Open Heart, 11(1) B M J Group 10.1136/openhrt-2023-002583
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OBJECTIVE
Residual sequelae after surgical repair of tetralogy of Fallot (rTOF) affect clinical outcome. We investigated the prognostic impact of right ventricular (RV) dyssynchrony in adults with rTOF years after the surgical repair.
METHODS
Patients from the Swiss Adult Congenital HEart disease Registry were included. NT-proBNP levels, echocardiography, exercise testing and MRI data were collected. An offline strain analysis to quantify RV-ventricular and interventricular dyssynchrony was performed. The standard deviation of the time-to-peak shortening (TTP) of six RV segments defined the RV Dyssynchrony Index (RVDI). Maximal difference of TTP between RV and left ventricular segments defined the interventricular shortening delay (IVSD). Predictors of a composite adverse event (arrhythmias, hospitalisation for heart failure and death) were identified by multivariate Cox regression analysis. Their median values were used to create a risk score.
RESULTS
Out of 285 included patients (mean age 34±14 years), 33 patients (12%) experienced an adverse event during a mean follow-up of 48±21 months. No correlation was found between RVDI, IVSD and clinical events. NT-proBNP, right atrial area and peak heart rate were independent predictors of outcomes. After 4 years-follow-up, no adverse events occurred in patients at low risk (score=0 points), while an adverse event occurred in 62% of patients at high risk (score=3 points, p<0.001).
CONCLUSION
In our cohort of adults with rTOF, surrogates of RV dyssynchrony did not correlate with outcomes. A multimodality approach was effective in predicting the risk for adverse events.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Nussbaumer, Clément Enrico, Goulouti, Eleni, Schwitz, Fabienne Muriel, Schwerzmann, Markus |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2053-3624 |
Publisher: |
B M J Group |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
22 Jan 2024 11:29 |
Last Modified: |
22 Jan 2024 11:38 |
Publisher DOI: |
10.1136/openhrt-2023-002583 |
PubMed ID: |
38242560 |
Uncontrolled Keywords: |
Diagnostic Imaging Echocardiography Tetralogy of Fallot |
BORIS DOI: |
10.48350/191943 |
URI: |
https://boris.unibe.ch/id/eprint/191943 |
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