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Longitudinal systolic ventricular interaction in pediatric and young adult patients with TOF: a cardiac magnetic resonance and M-mode echocardiographic study

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Abstract

Aim of this prospective study was to evaluate longitudinal systolic left ventricular (LV)–right ventricular (RV) interaction using M-mode compared to magnetic resonance imaging (MRI) data in 146 pediatric and adults with operated tetralogy of Fallot (TOF). We determined biventricular measures of longitudinal M-mode echocardiography [i.e. tricuspid annular plane systolic excursion (TAPSE); the mitral annular plane systolic excursion (MAPSE)] compared to longitudinal function parameters using MRI. M-mode data were compared to established normal z-score values. We found a good correlation between MAPSE and LVEF values (r = 0.788; p < 0.001). Correlations between MRI derived MAPSE and M-mode guided MAPSE (r = 0.879, p < 0.001), and between MRI derived TAPSE and M-mode guided TAPSE were significant (r = 0.780, p < 0.001). While the LVEF was normal in patients with a normal RVEF, the LVEF was decreased in patients with significantly reduced RVEF. Patients with a significantly dilated RV (RVEDVi > 150 ml/m2) showed a significantly reduced mean MAPSE of 1.30 ± 0.26 cm. LV longitudinal function decreases below −2 SD of normal MAPSE z-score values after a mean of 22 postoperative years. Our data confirm progressive adverse RV–LV interaction in the long-term follow-up of TOF. We show that simple M-mode measurement of the longitudinal LV function (i.e. MAPSE) is a sufficient surrogate for estimation of LVEF. Therefore determination of the MAPSE is a helpful additional tool for LV systolic function assessment late after TOF repair.

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Authors and Affiliations

  1. Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria

    Martin Koestenberger, Bert Nagel, Bernd Heinzl, Peter Fritsch, Thomas Rehak & Andreas Gamillscheg

  2. Division of Pediatric Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    William Ravekes

  3. Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, Graz, Austria

    Alexander Avian

  4. Division of Pediatric Radiology, Department of Radiology, Medical University Graz, Graz, Austria

    Erich Sorantin

  5. Centre of Physiological Medicine, Institute of Physiological Chemistry, Medical University Graz, Graz, Austria

    Gerhard Cvirn

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  1. Martin Koestenberger
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  2. William Ravekes
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  3. Bert Nagel
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Correspondence to Martin Koestenberger.

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Koestenberger, M., Ravekes, W., Nagel, B. et al. Longitudinal systolic ventricular interaction in pediatric and young adult patients with TOF: a cardiac magnetic resonance and M-mode echocardiographic study. Int J Cardiovasc Imaging 29, 1707–1715 (2013). https://doi.org/10.1007/s10554-013-0261-3

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  • DOI: https://doi.org/10.1007/s10554-013-0261-3

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