Cargando…
Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot
BACKGROUND: Unfavorable left ventricular (LV) remodelling may be associated with adverse outcomes after Tetralogy of Fallot (TOF) repair. We sought to assess T1 cardiovascular magnetic resonance (CMR) markers of diffuse LV myocardial fibrosis in children after TOF repair, and associated factors. MET...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5080785/ https://www.ncbi.nlm.nih.gov/pubmed/27782857 http://dx.doi.org/10.1186/s12968-016-0290-x |
_version_ | 1782462795507302400 |
---|---|
author | Riesenkampff, Eugénie Luining, Wietske Seed, Mike Chungsomprasong, Paweena Manlhiot, Cedric Elders, Bernadette McCrindle, Brian W. Yoo, Shi-Joon Grosse-Wortmann, Lars |
author_facet | Riesenkampff, Eugénie Luining, Wietske Seed, Mike Chungsomprasong, Paweena Manlhiot, Cedric Elders, Bernadette McCrindle, Brian W. Yoo, Shi-Joon Grosse-Wortmann, Lars |
author_sort | Riesenkampff, Eugénie |
collection | PubMed |
description | BACKGROUND: Unfavorable left ventricular (LV) remodelling may be associated with adverse outcomes after Tetralogy of Fallot (TOF) repair. We sought to assess T1 cardiovascular magnetic resonance (CMR) markers of diffuse LV myocardial fibrosis in children after TOF repair, and associated factors. METHODS: In this prospective, cross-sectional study, native (=non-contrast) T1 times and extracellular volume fraction (ECV) were quantified in the LV myocardium using CMR. Results were related to ventricular volumes and function, degree of pulmonary regurgitation, as well as surgical characteristics, and exercise capacity. RESULTS: There was no difference in native T1 times or ECV between 31 TOF patients (age at CMR 13.9 ± 2.4 years, 19 male) and 15 controls (age at CMR 13.4 ± 2.6 years, 7 male). Female TOF patients had higher ECVs than males (25.2 ± 2.9 % versus 22.7 ± 3.3 %, p < 0.05). In the patient group, higher native T1 and ECV correlated with higher Z-Scores of right and left ventricular end-diastolic volumes, but not with reduced left and right ventricular ejection fraction or higher pulmonary regurgitation fraction. Longer cardiopulmonary bypass and aortic cross clamp times at surgery correlated with increased native T1 times and ECVs (r = 0.48, p < 0.05 and r = 0.65, p < 0.01, respectively). Maximum workload (percent of predicted for normal) correlated inversely with ECV (r = -0.62, p < 0.05). Higher native T1 times correlated with worse LV longitudinal (r = 0.50, p < 0.05) and mid short axis circumferential strain (r = 0.38, p < 0.05). CONCLUSIONS: As compared to controls, TOF patients did not express higher markers of diffuse fibrosis. Longer cardiopulmonary bypass and aortic cross clamp times at surgery as well as biventricular enlargement and reduced exercise tolerance are associated with markers of diffuse myocardial fibrosis after TOF repair. Female patients have higher markers of diffuse myocardial fibrosis than males. |
format | Online Article Text |
id | pubmed-5080785 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-50807852016-10-31 Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot Riesenkampff, Eugénie Luining, Wietske Seed, Mike Chungsomprasong, Paweena Manlhiot, Cedric Elders, Bernadette McCrindle, Brian W. Yoo, Shi-Joon Grosse-Wortmann, Lars J Cardiovasc Magn Reson Research BACKGROUND: Unfavorable left ventricular (LV) remodelling may be associated with adverse outcomes after Tetralogy of Fallot (TOF) repair. We sought to assess T1 cardiovascular magnetic resonance (CMR) markers of diffuse LV myocardial fibrosis in children after TOF repair, and associated factors. METHODS: In this prospective, cross-sectional study, native (=non-contrast) T1 times and extracellular volume fraction (ECV) were quantified in the LV myocardium using CMR. Results were related to ventricular volumes and function, degree of pulmonary regurgitation, as well as surgical characteristics, and exercise capacity. RESULTS: There was no difference in native T1 times or ECV between 31 TOF patients (age at CMR 13.9 ± 2.4 years, 19 male) and 15 controls (age at CMR 13.4 ± 2.6 years, 7 male). Female TOF patients had higher ECVs than males (25.2 ± 2.9 % versus 22.7 ± 3.3 %, p < 0.05). In the patient group, higher native T1 and ECV correlated with higher Z-Scores of right and left ventricular end-diastolic volumes, but not with reduced left and right ventricular ejection fraction or higher pulmonary regurgitation fraction. Longer cardiopulmonary bypass and aortic cross clamp times at surgery correlated with increased native T1 times and ECVs (r = 0.48, p < 0.05 and r = 0.65, p < 0.01, respectively). Maximum workload (percent of predicted for normal) correlated inversely with ECV (r = -0.62, p < 0.05). Higher native T1 times correlated with worse LV longitudinal (r = 0.50, p < 0.05) and mid short axis circumferential strain (r = 0.38, p < 0.05). CONCLUSIONS: As compared to controls, TOF patients did not express higher markers of diffuse fibrosis. Longer cardiopulmonary bypass and aortic cross clamp times at surgery as well as biventricular enlargement and reduced exercise tolerance are associated with markers of diffuse myocardial fibrosis after TOF repair. Female patients have higher markers of diffuse myocardial fibrosis than males. BioMed Central 2016-10-26 /pmc/articles/PMC5080785/ /pubmed/27782857 http://dx.doi.org/10.1186/s12968-016-0290-x Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Riesenkampff, Eugénie Luining, Wietske Seed, Mike Chungsomprasong, Paweena Manlhiot, Cedric Elders, Bernadette McCrindle, Brian W. Yoo, Shi-Joon Grosse-Wortmann, Lars Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot |
title | Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot |
title_full | Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot |
title_fullStr | Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot |
title_full_unstemmed | Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot |
title_short | Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot |
title_sort | increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of tetralogy of fallot |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5080785/ https://www.ncbi.nlm.nih.gov/pubmed/27782857 http://dx.doi.org/10.1186/s12968-016-0290-x |
work_keys_str_mv | AT riesenkampffeugenie increasedleftventricularmyocardialextracellularvolumeisassociatedwithlongercardiopulmonarybypasstimesbiventricularenlargementandreducedexercisetoleranceinchildrenafterrepairoftetralogyoffallot AT luiningwietske increasedleftventricularmyocardialextracellularvolumeisassociatedwithlongercardiopulmonarybypasstimesbiventricularenlargementandreducedexercisetoleranceinchildrenafterrepairoftetralogyoffallot AT seedmike increasedleftventricularmyocardialextracellularvolumeisassociatedwithlongercardiopulmonarybypasstimesbiventricularenlargementandreducedexercisetoleranceinchildrenafterrepairoftetralogyoffallot AT chungsomprasongpaweena increasedleftventricularmyocardialextracellularvolumeisassociatedwithlongercardiopulmonarybypasstimesbiventricularenlargementandreducedexercisetoleranceinchildrenafterrepairoftetralogyoffallot AT manlhiotcedric increasedleftventricularmyocardialextracellularvolumeisassociatedwithlongercardiopulmonarybypasstimesbiventricularenlargementandreducedexercisetoleranceinchildrenafterrepairoftetralogyoffallot AT eldersbernadette increasedleftventricularmyocardialextracellularvolumeisassociatedwithlongercardiopulmonarybypasstimesbiventricularenlargementandreducedexercisetoleranceinchildrenafterrepairoftetralogyoffallot AT mccrindlebrianw increasedleftventricularmyocardialextracellularvolumeisassociatedwithlongercardiopulmonarybypasstimesbiventricularenlargementandreducedexercisetoleranceinchildrenafterrepairoftetralogyoffallot AT yooshijoon increasedleftventricularmyocardialextracellularvolumeisassociatedwithlongercardiopulmonarybypasstimesbiventricularenlargementandreducedexercisetoleranceinchildrenafterrepairoftetralogyoffallot AT grossewortmannlars increasedleftventricularmyocardialextracellularvolumeisassociatedwithlongercardiopulmonarybypasstimesbiventricularenlargementandreducedexercisetoleranceinchildrenafterrepairoftetralogyoffallot |