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Preliminary Assessment of Tricuspid Valve Annular Velocity Parameters by Cardiac Magnetic Resonance Imaging in Adults with a Volume-Overloaded Right Ventricle: Comparison of Unrepaired Atrial Septal Defect and Repaired Tetralogy of Fallot

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Abstract

The aim is to compare tricuspid valve (TV) atrioventricular junction (AVJ) annular motion parameters in unrepaired atrial septal defect (ASD) and repaired Tetralogy of Fallot (TOF) by cardiac magnetic resonance (CMR) imaging. We retrospectively reviewed CMR studies performed between November 2007 and November 2013 in patients 16–45 years of age with unrepaired ASD (with or without partial anomalous pulmonary venous return) and with repaired TOF, who had previous infundibulotomy, but have not undergone pulmonary valve replacement. Longitudinal motion of lateral TV in four-chamber view cine image was tracked through the cardiac cycle with custom software. Twenty TOF patients and 12 ASD patients were included, and values were compared with 80 controls. Right ventricular end-diastolic volume index and right ventricular end-systolic volume index were similar in the ASD and TOF groups and were significantly higher in both groups than in controls. Maximum displacement of the TV in systole, velocity at half-maximal displacement during systole, and velocity at half-maximal displacement during early diastole were all significantly lower in the TOF group than the ASD group [1.39 ± 0.47 vs. 2.21 ± 0.46 (cm, p < 0.01), 5.9 ± 2.1 vs. 10.1 ± 2.3 (cm/s, p < 0.01), and 7.7 ± 2.6 vs. 10.9 ± 3.1 (cm/s, p < 0.05)]. TOF patients have diminished early diastolic TV AVJ velocity compared to patients with an unrepaired ASD, despite similar RV volumes. This observation could suggest diastolic dysfunction or cardiac mechanics unique to the postoperative, volume-overloaded right ventricle in patients with repaired TOF.

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Acknowledgments

We thank James Babb, Ph.D., for assisting with the statistical analysis. This study was supported by the National Institutes of Health under Award Number 1R21HL108218-01.

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Authors and Affiliations

  1. Department of Pediatrics, Pediatric Cardiology, New York University Langone Medical Center, 550 1st Avenue, New York, NY, 10016, USA

    Seiji Ito, Doff B. McElhinney, Robert Adams & Puneet Bhatla

  2. Department of Radiology, New York University School of Medicine, New York, NY, USA

    Sohae Chung & Leon Axel

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  1. Seiji Ito
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  2. Doff B. McElhinney
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  3. Robert Adams
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  4. Puneet Bhatla
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Correspondence to Seiji Ito.

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Ito, S., McElhinney, D.B., Adams, R. et al. Preliminary Assessment of Tricuspid Valve Annular Velocity Parameters by Cardiac Magnetic Resonance Imaging in Adults with a Volume-Overloaded Right Ventricle: Comparison of Unrepaired Atrial Septal Defect and Repaired Tetralogy of Fallot. Pediatr Cardiol 36, 1294–1300 (2015). https://doi.org/10.1007/s00246-015-1160-2

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  • DOI: https://doi.org/10.1007/s00246-015-1160-2

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