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- Title
Le Cœur en Sabot: shape associations with adverse events in repaired tetralogy of Fallot.
- Authors
Mîra, Anna; Lamata, Pablo; Pushparajah, Kuberan; Abraham, Georgina; Mauger, Charlène A.; McCulloch, Andrew D.; Omens, Jeffrey H.; Bissell, Malenka M.; Blair, Zach; Huffaker, Tyler; Tandon, Animesh; Engelhardt, Sandy; Koehler, Sven; Pickardt, Thomas; Beerbaum, Philipp; Sarikouch, Samir; Latus, Heiner; Greil, Gerald; Young, Alistair A.; Hussain, Tarique
- Abstract
Background: Maladaptive remodelling mechanisms occur in patients with repaired tetralogy of Fallot (rToF) resulting in a cycle of metabolic and structural changes. Biventricular shape analysis may indicate mechanisms associated with adverse events independent of pulmonary regurgitant volume index (PRVI). We aimed to determine novel remodelling patterns associated with adverse events in patients with rToF using shape and function analysis. Methods: Biventricular shape and function were studied in 192 patients with rToF (median time from TOF repair to baseline evaluation 13.5 years). Linear discriminant analysis (LDA) and principal component analysis (PCA) were used to identify shape differences between patients with and without adverse events. Adverse events included death, arrhythmias, and cardiac arrest with median follow-up of 10 years. Results: LDA and PCA showed that shape characteristics pertaining to adverse events included a more circular left ventricle (LV) (decreased eccentricity), dilated (increased sphericity) LV base, increased right ventricular (RV) apical sphericity, and decreased RV basal sphericity. Multivariate LDA showed that the optimal discriminative model included only RV apical ejection fraction and one PCA mode associated with a more circular and dilated LV base (AUC = 0.77). PRVI did not add value, and shape changes associated with increased PRVI were not predictive of adverse outcomes. Conclusion: Pathological remodelling patterns in patients with rToF are significantly associated with adverse events, independent of PRVI. Mechanisms related to incident events include LV basal dilation with a reduced RV apical ejection fraction.
- Subjects
BIOMARKERS; VENTRICULAR ejection fraction; TETRALOGY of Fallot; MAGNETIC resonance imaging; DISCRIMINANT analysis; HEART ventricles; FACTOR analysis; CARDIAC arrest; ADVERSE health care events
- Publication
Journal of Cardiovascular Magnetic Resonance (BioMed Central), 2022, Vol 24, Issue 1, p1
- ISSN
1532-429X
- Publication type
Article
- DOI
10.1186/s12968-022-00877-x