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Delayed enhancement imaging in a contemporary patient cohort following correction of tetralogy of Fallot

Published online by Cambridge University Press:  10 November 2014

Uta Preim ,
Philipp Sommer ,
Janine Hoffmann ,
Jana Kehrmann ,
Lukas Lehmkuhl ,
Ingo Daehnert ,
Matthias Gutberlet  and
Matthias Grothoff
Uta Preim*
Affiliation:
Department of Radiology, University of Leipzig – Heart Center, Leipzig, Germany
Philipp Sommer
Affiliation:
Department of Electrophysiology, University of Leipzig – Heart Center, Leipzig, Germany
Janine Hoffmann
Affiliation:
Department of Radiology, University of Leipzig – Heart Center, Leipzig, Germany
Jana Kehrmann
Affiliation:
Department of Radiology, University of Leipzig – Heart Center, Leipzig, Germany
Lukas Lehmkuhl
Affiliation:
Department of Radiology, University of Leipzig – Heart Center, Leipzig, Germany
Ingo Daehnert
Affiliation:
Department of Congenital Heart Disease/Pediatric Cardiology, University of Leipzig – Heart Center, Leipzig, Germany
Matthias Gutberlet
Affiliation:
Department of Radiology, University of Leipzig – Heart Center, Leipzig, Germany
Matthias Grothoff
Affiliation:
Department of Radiology, University of Leipzig – Heart Center, Leipzig, Germany
*
Correspondence to: Dr U. Preim, MD, Department of Radiology, University of Leipzig – Heart Center, Struempellstr. 39, 04289 Leipzig, Germany. Tel: 0341 865 1702; Fax: 0341 865 1803; E-mail: [email protected]
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Abstract

Objective

To test the hypothesis that myocardial scars after repair of tetralogy of Fallot are related to impaired cardiac function and adverse clinical outcome.

Methods

A total of 53 patients were retrospectively analysed after repair of tetralogy of Fallot. The median patient age was 20 years (range 2–48).

Cardiac MRI with a 1.5 T magnet included cine sequences to obtain volumes and function, phase-sensitive inversion recovery delayed enhancement imaging to detect myocardial scars, and flow measurements to determine pulmonary regurgitation fraction. In addition, clinical parameters were obtained.

Results

An overall 83% of patients were in NYHA class I. All patients with the exception of 2 (96%) had pulmonary insufficiency. Mean ejection fraction and end-diastolic volume index were 46% and 128 ml/m2 for the right ventricle and 54% and 82 ml/m2 for the left ventricle, respectively. Excluding enhancement of the septal insertion and prosthetic patches, delayed enhancement was seen in 11/53 cases (21%). Delayed enhancement of the right ventricle was detected in 6/53 patients (11%) and of the left ventricle in 5/53 patients (9%). The patient group with delayed enhancement was significantly older (p=0.003), had later repair (p=0.007), and higher left ventricular myocardial mass index (p=0.009) compared with the group without delayed enhancement.

Conclusions

This study reveals that scarring is common in patients after surgical repair of tetralogy of Fallot and is associated with older age and late repair. However, there was no difference in right ventricular function, NYHA class, or occurrence of clinically relevant arrhythmias between patients with and those without myocardial scars.

Keywords

Cardiac magnetic resonancedelayed enhancement imagingtetralogy of Fallotright ventricular function
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 7 , October 2015 , pp. 1268 - 1275
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Copyright
© Cambridge University Press 2014 

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Footnotes

*

The first two authors contributed equally to this work

**

The last two authors should be considered as senior authors.

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