Impact of Gender and Age on Cardiovascular Function Late After Repair of Tetralogy of Fallot
Open Access
- 1 November 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation: Cardiovascular Imaging
- Vol. 4 (6), 703-711
- https://doi.org/10.1161/circimaging.111.963637
Abstract
Background—: The impact of gender and age on cardiac function by cardiac magnetic resonance (CMR) in repaired tetralogy of Fallot (TOF) is unknown, which limits the value of currently discussed volumetric thresholds and the accuracy of individual follow-up. Methods and Results—: In a nationwide, prospective, 14-center study, 407 consecutive patients with repaired TOF (age, 17.9±8.3 years; range, 8–59 years; 226 male patients) underwent standardized CMR ventricular volumetry and flow quantification (pulmonary artery/ascending aorta). There were no sex differences for age at TOF repair, type of repair, number of prior repair palliations or reinterventions after repair, pulmonary regurgitation fraction, and maximal gradient across the right ventricular outflow tract. Biventricular volumes and mass (indexed to body surface area), available in 380 of 407 patients, respectively, were higher in male patients ( P P <0.012). As opposed to reported data of healthy populations, sex-specific reference percentiles computed for an age range of 8 to 40 years (lambda-mu-sigma method) demonstrated (1) an increase of end-diastolic and end-systolic left ventricular volumes, particularly in female patients; (2) an increase of end-systolic right ventricular volumes in both sexes; and (3) a decrease of biventricular ejection fraction in male patients, whereas in female patients, only right ventricular ejection fraction decreased. Conclusions—: Significant gender differences of biventricular volumes, function, and mass by CMR exist late after repair of TOF, suggesting that age and gender cannot be ignored when discussing thresholds. Gender-specific percentiles may present a more relevant framework of reference for an individual patient at a given age and suggest a gradual decline of biventricular systolic function over time. Clinical Trial Registration—: URL: http://www.clinicaltrials.gov . Unique identifier: NCT00266188.Keywords
This publication has 24 references indexed in Scilit:
- Prevalence of Congenital Heart Defects in Newborns in Germany: Results of the First Registration Year of the PAN Study (July 2006 to June 2007)Klinische Padiatrie, 2010
- Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: Outflow tract obstruction, coarctation of the aorta, tetralogy of Fallot, Ebstein anomaly and Marfan's syndromeCanadian Journal of Cardiology, 2010
- Sex-Specific Pediatric Percentiles for Ventricular Size and Mass as Reference Values for Cardiac MRICirculation: Cardiovascular Imaging, 2010
- Tetralogy of FallotThe Lancet, 2009
- Cardiac function by MRI in congenital heart disease: Impact of consensus training on interinstitutional varianceJournal of Magnetic Resonance Imaging, 2009
- Effects of Regional Dysfunction and Late Gadolinium Enhancement on Global Right Ventricular Function and Exercise Capacity in Patients With Repaired Tetralogy of FallotCirculation, 2009
- Normal biventricular function, volumes, and mass in children aged 8 to 17 yearsJournal of Magnetic Resonance Imaging, 2009
- Normal right- and left ventricular volumes and myocardial mass in children measured by steady state free precession cardiovascular magnetic resonanceJournal of Cardiovascular Magnetic Resonance, 2009
- Smoothing reference centile curves: The lms method and penalized likelihoodStatistics in Medicine, 1992
- Direct Vision Intracardiac Surgical Correction of the Tetralogv of Fallot, Pentalogy of Fallot, and Pulmonary Atresia DefectsAnnals of Surgery, 1955