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Cited by 39Congenital Heart Disease StudiesCardiovascular Function and Risk FactorsCardiac Valve Diseases and Treatments

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The Prognostic Value of Myocardial Deformation in Adult Patients With Corrected Tetralogy of Fallot

van Grootel, Roderick W.J., van den Bosch, Annemien E., Baggen, Vivan J.M., Menting, Myrthe E., Baart, Sara J., Cuypers, Judith A.A.E., Witsenburg, Maarten, Roos-Hesselink, Jolien W.·2019·Journal of the American Society of Echocardiography
DOI 10.1016/j.echo.2019.03.014
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Abstract

Background Adult patients with repaired tetralogy of Fallot (ToF) are at risk for complications such as heart failure and sudden cardiac death, and identifying high-risk patients is important. Reduced left ventricular (LV) and right ventricular (RV) function has been identified as a predictor of outcomes. However, LV ejection fraction is often preserved, and RV function is difficult to assess. With the introduction of strain analysis, an easy and more sensitive parameter became available. The aim of this study was to investigate the association between strain variables and cardiovascular events in patients with ToF. Methods Stable adult patients with repaired ToF were consecutively included in a prospective observational study between 2011 and 2013 (N = 151; median age, 33.2 years [interquartile range, 25.5-42.0 years]; 61.6% men). For the left ventricle, global longitudinal strain and apical and basal rotation were measured, and longitudinal strain was measured for the right ventricle. The primary endpoint was a composite of death or heart failure. The secondary endpoint was a composite of death, heart failure, arrhythmia, reintervention, or hospitalization for cardiac reasons. Results During a median follow-up period of 71.5 months (interquartile range, 64.0-75.3 months), the primary and secondary endpoints occurred in 14 (9%) and 62 (41%) patients, respectively. After adjusting for LV ejection fraction and LV global longitudinal strain, RV longitudinal strain remained independently associated with the primary endpoint in a ridge regression analysis. LV apical rotation remained independently associated with the secondary end point (adjusted hazard ratio, 0.72; 95% CI, 0.52-0.98; P = .035) after adjusting for age, New York Heart Association functional class, QRS duration, LV ejection fraction, RV longitudinal strain, and LV global longitudinal strain. Conclusions Myocardial deformation variables of both the left and right ventricles were associated with cardiovascular events in patients with ToF. LV and RV longitudinal strain and LV rotation should become part of the routine assessment of patients with ToF.

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  • A reduction in septal strain has usually been observed in TOF.

    “A reduction in septal strain has usually been observed, indicating that right ventricular (RV) dysfunction has a negative impact on left ventricular (LV) function, potentially through mechanical interdependence between the two ventricles [20].”

    From Multimodality imaging assessment of tetralogy of Fallot: From diagnosis to long-term follow-up (2023) · cites this paper as [20]

  • RV dysfunction has a negative impact on LV function, potentially through mechanical interdependence between the two ventricles.

    “A reduction in septal strain has usually been observed, indicating that right ventricular (RV) dysfunction has a negative impact on left ventricular (LV) function, potentially through mechanical interdependence between the two ventricles [20].”

    From Multimodality imaging assessment of tetralogy of Fallot: From diagnosis to long-term follow-up (2023) · cites this paper as [20]

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Metadata

Authors
van Grootel, R. W. J., van den Bosch, A. E., Baggen, V. J. M., Menting, M. E., Baart, S. J., Cuypers, J. A. A. E., Witsenburg, M., & Roos-Hesselink, J. W.
Affiliations
Erasmus MC (NL)
ORCID
Venue
Journal of the American Society of Echocardiography
Publisher
Elsevier BV
Published
2019-07
Volume
32
Issue
7
Pages
866-875.e2
ISSN
0894-7317 (ISSN-L)
DOI
10.1016/j.echo.2019.03.014
OpenAlex
W2944709914
Cited by
39
References
39
Citations by year
2026: 3 · 2025: 5 · 2024: 6 · 2023: 8 · 2022: 4 · 2021: 9 · 2020: 4
FWCI
3.26
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of the American Society of Echocardiography (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
Keywords
tetralogy of Fallot, repaired congenital heart disease, myocardial deformation, myocardial strain, right ventricular longitudinal strain, left ventricular global longitudinal strain, heart failure, sudden cardiac death, cardiac arrhythmias, cardiovascular events, prognosis, adult congenital heart disease
MeSH terms
Adult, Female, Humans, Male, Prognosis, Prospective Studies, Risk Factors, Tetralogy of Fallot, Ventricular Dysfunction, Left, Ventricular Dysfunction, Right

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