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Long-term follow-up in adults after tetralogy of Fallot repair

BACKGROUND: Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart disease and the population of ToF repair survivors is growing rapidly. Adults with repaired ToF develop late complications. The aim of this study was to describe and analyze long-term follow-up of patients with repair...

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Autores principales: Dłużniewska, Natalia, Podolec, Piotr, Skubera, Maciej, Smaś-Suska, Monika, Pająk, Jacek, Urbańczyk-Zawadzka, Małgorzata, Płazak, Wojciech, Olszowska, Maria, Tomkiewicz-Pająk, Lidia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206664/
https://www.ncbi.nlm.nih.gov/pubmed/30373624
http://dx.doi.org/10.1186/s12947-018-0146-7
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author Dłużniewska, Natalia
Podolec, Piotr
Skubera, Maciej
Smaś-Suska, Monika
Pająk, Jacek
Urbańczyk-Zawadzka, Małgorzata
Płazak, Wojciech
Olszowska, Maria
Tomkiewicz-Pająk, Lidia
author_facet Dłużniewska, Natalia
Podolec, Piotr
Skubera, Maciej
Smaś-Suska, Monika
Pająk, Jacek
Urbańczyk-Zawadzka, Małgorzata
Płazak, Wojciech
Olszowska, Maria
Tomkiewicz-Pająk, Lidia
author_sort Dłużniewska, Natalia
collection PubMed
description BACKGROUND: Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart disease and the population of ToF repair survivors is growing rapidly. Adults with repaired ToF develop late complications. The aim of this study was to describe and analyze long-term follow-up of patients with repaired ToF. METHODS: This is a retrospective cohort study. Consecutive 83 patients with repaired ToF who did not undergo pulmonary valve replacement were included. Mean age of all patients was 30.5 ± 10.7. There were 49 (59%) male. Patients were divided into two groups according to the time since the repair (< 25 years and ≥ 25 years). The electrocardiographic (ECG), cardiopulmonary exercise testing (CPET), echocardiographic and cardiac magnetic resonance (CMR) data were reviewed retrospectively. RESULTS: In CPET values were not significantly different in the two groups. In CMR volumes of left and right ventricles were not significantly different in the two groups. There were no differences between the groups in ventricular ejection fraction, mass of ventricles, or pulmonary regurgitation fraction. Among all the patients, ejection fraction and left and right ventricle mass, indexed pulmonary regurgitation volume measured by CMR did not correlate with the time since repair. In ECG among all the patients, ejection fraction of the RV, measured in CMR, negatively correlated with QRS duration (r = − 0.43; p < 0.001). There was a positive correlation between QRS duration and end diastolic volume of the RV (r = 0.30; p < 0.02), indexed end diastolic volume of the RV (r = 0.29; p = 0.04), RV mass (r = 0.36; p < 0.001) and left ventricle mass (r = 0.26; p = 0.04). CONCLUSION: Long-term survival and clinical condition after surgical correction of ToF in infancy is generally good and the late functional status in ToF – operated patients could be excellent up to 25 years after the repair. QRS duration could be an utility and easy factor to assessment of right ventricular function. TRIAL REGISTRATION: The study protocol was approved by the local Ethics Committee. Each participant provided informed consent to participate in the study (license number 122.6120.88.2016 from 28.04.2016).
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spelling pubmed-62066642018-10-31 Long-term follow-up in adults after tetralogy of Fallot repair Dłużniewska, Natalia Podolec, Piotr Skubera, Maciej Smaś-Suska, Monika Pająk, Jacek Urbańczyk-Zawadzka, Małgorzata Płazak, Wojciech Olszowska, Maria Tomkiewicz-Pająk, Lidia Cardiovasc Ultrasound Research BACKGROUND: Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart disease and the population of ToF repair survivors is growing rapidly. Adults with repaired ToF develop late complications. The aim of this study was to describe and analyze long-term follow-up of patients with repaired ToF. METHODS: This is a retrospective cohort study. Consecutive 83 patients with repaired ToF who did not undergo pulmonary valve replacement were included. Mean age of all patients was 30.5 ± 10.7. There were 49 (59%) male. Patients were divided into two groups according to the time since the repair (< 25 years and ≥ 25 years). The electrocardiographic (ECG), cardiopulmonary exercise testing (CPET), echocardiographic and cardiac magnetic resonance (CMR) data were reviewed retrospectively. RESULTS: In CPET values were not significantly different in the two groups. In CMR volumes of left and right ventricles were not significantly different in the two groups. There were no differences between the groups in ventricular ejection fraction, mass of ventricles, or pulmonary regurgitation fraction. Among all the patients, ejection fraction and left and right ventricle mass, indexed pulmonary regurgitation volume measured by CMR did not correlate with the time since repair. In ECG among all the patients, ejection fraction of the RV, measured in CMR, negatively correlated with QRS duration (r = − 0.43; p < 0.001). There was a positive correlation between QRS duration and end diastolic volume of the RV (r = 0.30; p < 0.02), indexed end diastolic volume of the RV (r = 0.29; p = 0.04), RV mass (r = 0.36; p < 0.001) and left ventricle mass (r = 0.26; p = 0.04). CONCLUSION: Long-term survival and clinical condition after surgical correction of ToF in infancy is generally good and the late functional status in ToF – operated patients could be excellent up to 25 years after the repair. QRS duration could be an utility and easy factor to assessment of right ventricular function. TRIAL REGISTRATION: The study protocol was approved by the local Ethics Committee. Each participant provided informed consent to participate in the study (license number 122.6120.88.2016 from 28.04.2016). BioMed Central 2018-10-29 /pmc/articles/PMC6206664/ /pubmed/30373624 http://dx.doi.org/10.1186/s12947-018-0146-7 Text en © The Author(s). 2018 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
Dłużniewska, Natalia
Podolec, Piotr
Skubera, Maciej
Smaś-Suska, Monika
Pająk, Jacek
Urbańczyk-Zawadzka, Małgorzata
Płazak, Wojciech
Olszowska, Maria
Tomkiewicz-Pająk, Lidia
Long-term follow-up in adults after tetralogy of Fallot repair
title Long-term follow-up in adults after tetralogy of Fallot repair
title_full Long-term follow-up in adults after tetralogy of Fallot repair
title_fullStr Long-term follow-up in adults after tetralogy of Fallot repair
title_full_unstemmed Long-term follow-up in adults after tetralogy of Fallot repair
title_short Long-term follow-up in adults after tetralogy of Fallot repair
title_sort long-term follow-up in adults after tetralogy of fallot repair
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206664/
https://www.ncbi.nlm.nih.gov/pubmed/30373624
http://dx.doi.org/10.1186/s12947-018-0146-7
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