Risk Factors of Right Ventricular Dysfunction and Adverse Cardiac Events in Patients with Repaired Tetralogy of Fallot

Benedetta Leonardi; Camilla Calvieri; Marco Alfonso Perrone; Arianna Di Rocco; Adriano Carotti; Massimo Caputo; Aurelio Secinaro; Davide Curione; Maria Giulia Gagliardi; Paolo Guccione; Sonia Albanese; Lorenzo Galletti; Fabrizio Drago

doi:10.3390/ijerph181910549

Risk Factors of Right Ventricular Dysfunction and Adverse Cardiac Events in Patients with Repaired Tetralogy of Fallot

Benedetta Leonardi, Camilla Calvieri, Marco Alfonso Perrone, Arianna Di Rocco, Adriano Carotti, Massimo Caputo, Aurelio Secinaro, Davide Curione, Maria Giulia Gagliardi, Paolo Guccione, Sonia Albanese, Lorenzo Galletti, Fabrizio Drago

Bristol Medical School (THS)

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Abstract

AIM: This study evaluates the risk factors associated with right ventricular (RV) dilation and dysfunction leading to pulmonary valve replacement (PVR) or adverse cardiac events in repaired Tetralogy of Fallot (rToF) patients.

METHODS: Data from all rToF patients who underwent magnetic resonance imaging (MRI) evaluation at our hospital between February 2007 and September 2020 were collected.

RESULTS: Three hundred and forty-two patients (60% males, 42% older than 18 years), with a median age of 16 years (IQR 13-24) at the time of MRI, were included. All patients underwent complete repair at a median age of 8 months (IQR 5-16), while palliation was performed in 56 patients (16%). One hundred and forty-four patients (42%) subsequently received pulmonary valve replacement (PVR). At the multivariate analysis, male gender was an independent predictor for significant RV dilation, RV and left ventricular (LV) dysfunction. Transventricular ventricular septal defect (VSD) closure and previous palliation significantly affected LV function and RV size, respectively. Male gender and the transventricular VSD closure were independent predictors for PVR.

CONCLUSIONS: Male gender and surgical history (palliation, VSD closure approach) significantly affected the long-term outcomes in rToF patients and should be taken into consideration in the follow-up management and in PVR timing in this patient population.

Original language	English
Article number	10549
Journal	International Journal of Environmental Research and Public Health
Volume	18
Issue number	19
Early online date	8 Oct 2021
DOIs	https://doi.org/10.3390/ijerph181910549
Publication status	Published - 8 Oct 2021

Bibliographical note

Funding Information:
Funding: This research received no specific grant from any funding agency, commercial or not-for-profit. MC was supported by the British Heart Foundation and the Bristol NIHR Biomedical Research Centre.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

Adolescent
Adult
Female
Heart Valve Prosthesis Implantation
Humans
Infant
Male
Pulmonary Valve Insufficiency/diagnostic imaging
Risk Factors
Tetralogy of Fallot/epidemiology
Treatment Outcome
Ventricular Dysfunction, Right/epidemiology
Ventricular Function, Right
Young Adult

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Leonardi, B., Calvieri, C., Perrone, M. A., Di Rocco, A., Carotti, A., Caputo, M., Secinaro, A., Curione, D., Gagliardi, M. G., Guccione, P., Albanese, S., Galletti, L., & Drago, F. (2021). Risk Factors of Right Ventricular Dysfunction and Adverse Cardiac Events in Patients with Repaired Tetralogy of Fallot. International Journal of Environmental Research and Public Health, 18(19), Article 10549. https://doi.org/10.3390/ijerph181910549

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title = "Risk Factors of Right Ventricular Dysfunction and Adverse Cardiac Events in Patients with Repaired Tetralogy of Fallot",

abstract = "AIM: This study evaluates the risk factors associated with right ventricular (RV) dilation and dysfunction leading to pulmonary valve replacement (PVR) or adverse cardiac events in repaired Tetralogy of Fallot (rToF) patients.METHODS: Data from all rToF patients who underwent magnetic resonance imaging (MRI) evaluation at our hospital between February 2007 and September 2020 were collected.RESULTS: Three hundred and forty-two patients (60\% males, 42\% older than 18 years), with a median age of 16 years (IQR 13-24) at the time of MRI, were included. All patients underwent complete repair at a median age of 8 months (IQR 5-16), while palliation was performed in 56 patients (16\%). One hundred and forty-four patients (42\%) subsequently received pulmonary valve replacement (PVR). At the multivariate analysis, male gender was an independent predictor for significant RV dilation, RV and left ventricular (LV) dysfunction. Transventricular ventricular septal defect (VSD) closure and previous palliation significantly affected LV function and RV size, respectively. Male gender and the transventricular VSD closure were independent predictors for PVR.CONCLUSIONS: Male gender and surgical history (palliation, VSD closure approach) significantly affected the long-term outcomes in rToF patients and should be taken into consideration in the follow-up management and in PVR timing in this patient population.",

keywords = "Adolescent, Adult, Female, Heart Valve Prosthesis Implantation, Humans, Infant, Male, Pulmonary Valve Insufficiency/diagnostic imaging, Risk Factors, Tetralogy of Fallot/epidemiology, Treatment Outcome, Ventricular Dysfunction, Right/epidemiology, Ventricular Function, Right, Young Adult",

author = "Benedetta Leonardi and Camilla Calvieri and Perrone, \{Marco Alfonso\} and \{Di Rocco\}, Arianna and Adriano Carotti and Massimo Caputo and Aurelio Secinaro and Davide Curione and Gagliardi, \{Maria Giulia\} and Paolo Guccione and Sonia Albanese and Lorenzo Galletti and Fabrizio Drago",

note = "Funding Information: Funding: This research received no specific grant from any funding agency, commercial or not-for-profit. MC was supported by the British Heart Foundation and the Bristol NIHR Biomedical Research Centre. Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2021",

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Leonardi, B, Calvieri, C, Perrone, MA, Di Rocco, A, Carotti, A, Caputo, M, Secinaro, A, Curione, D, Gagliardi, MG, Guccione, P, Albanese, S, Galletti, L & Drago, F 2021, 'Risk Factors of Right Ventricular Dysfunction and Adverse Cardiac Events in Patients with Repaired Tetralogy of Fallot', International Journal of Environmental Research and Public Health, vol. 18, no. 19, 10549. https://doi.org/10.3390/ijerph181910549

Risk Factors of Right Ventricular Dysfunction and Adverse Cardiac Events in Patients with Repaired Tetralogy of Fallot. / Leonardi, Benedetta; Calvieri, Camilla; Perrone, Marco Alfonso et al.
In: International Journal of Environmental Research and Public Health, Vol. 18, No. 19, 10549, 08.10.2021.

Research output: Contribution to journal › Article (Academic Journal) › peer-review

TY - JOUR

T1 - Risk Factors of Right Ventricular Dysfunction and Adverse Cardiac Events in Patients with Repaired Tetralogy of Fallot

AU - Leonardi, Benedetta

AU - Calvieri, Camilla

AU - Perrone, Marco Alfonso

AU - Di Rocco, Arianna

AU - Carotti, Adriano

AU - Caputo, Massimo

AU - Secinaro, Aurelio

AU - Curione, Davide

AU - Gagliardi, Maria Giulia

AU - Guccione, Paolo

AU - Albanese, Sonia

AU - Galletti, Lorenzo

AU - Drago, Fabrizio

N1 - Funding Information: Funding: This research received no specific grant from any funding agency, commercial or not-for-profit. MC was supported by the British Heart Foundation and the Bristol NIHR Biomedical Research Centre. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2021/10/8

Y1 - 2021/10/8

N2 - AIM: This study evaluates the risk factors associated with right ventricular (RV) dilation and dysfunction leading to pulmonary valve replacement (PVR) or adverse cardiac events in repaired Tetralogy of Fallot (rToF) patients.METHODS: Data from all rToF patients who underwent magnetic resonance imaging (MRI) evaluation at our hospital between February 2007 and September 2020 were collected.RESULTS: Three hundred and forty-two patients (60% males, 42% older than 18 years), with a median age of 16 years (IQR 13-24) at the time of MRI, were included. All patients underwent complete repair at a median age of 8 months (IQR 5-16), while palliation was performed in 56 patients (16%). One hundred and forty-four patients (42%) subsequently received pulmonary valve replacement (PVR). At the multivariate analysis, male gender was an independent predictor for significant RV dilation, RV and left ventricular (LV) dysfunction. Transventricular ventricular septal defect (VSD) closure and previous palliation significantly affected LV function and RV size, respectively. Male gender and the transventricular VSD closure were independent predictors for PVR.CONCLUSIONS: Male gender and surgical history (palliation, VSD closure approach) significantly affected the long-term outcomes in rToF patients and should be taken into consideration in the follow-up management and in PVR timing in this patient population.

AB - AIM: This study evaluates the risk factors associated with right ventricular (RV) dilation and dysfunction leading to pulmonary valve replacement (PVR) or adverse cardiac events in repaired Tetralogy of Fallot (rToF) patients.METHODS: Data from all rToF patients who underwent magnetic resonance imaging (MRI) evaluation at our hospital between February 2007 and September 2020 were collected.RESULTS: Three hundred and forty-two patients (60% males, 42% older than 18 years), with a median age of 16 years (IQR 13-24) at the time of MRI, were included. All patients underwent complete repair at a median age of 8 months (IQR 5-16), while palliation was performed in 56 patients (16%). One hundred and forty-four patients (42%) subsequently received pulmonary valve replacement (PVR). At the multivariate analysis, male gender was an independent predictor for significant RV dilation, RV and left ventricular (LV) dysfunction. Transventricular ventricular septal defect (VSD) closure and previous palliation significantly affected LV function and RV size, respectively. Male gender and the transventricular VSD closure were independent predictors for PVR.CONCLUSIONS: Male gender and surgical history (palliation, VSD closure approach) significantly affected the long-term outcomes in rToF patients and should be taken into consideration in the follow-up management and in PVR timing in this patient population.

KW - Adolescent

KW - Adult

KW - Female

KW - Heart Valve Prosthesis Implantation

KW - Humans

KW - Infant

KW - Male

KW - Pulmonary Valve Insufficiency/diagnostic imaging

KW - Risk Factors

KW - Tetralogy of Fallot/epidemiology

KW - Treatment Outcome

KW - Ventricular Dysfunction, Right/epidemiology

KW - Ventricular Function, Right

KW - Young Adult

U2 - 10.3390/ijerph181910549

DO - 10.3390/ijerph181910549

M3 - Article (Academic Journal)

C2 - 34639849

SN - 1661-7827

VL - 18

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

IS - 19

M1 - 10549

ER -

Risk Factors of Right Ventricular Dysfunction and Adverse Cardiac Events in Patients with Repaired Tetralogy of Fallot

Abstract

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