Document Detail


Relation of Left Ventricular Dyssynchrony Measured by Cardiac Magnetic Resonance Tissue Tracking in Repaired Tetralogy of Fallot to Ventricular Tachycardia and Death.
MedLine Citation:
PMID:  21414597     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The impact of left ventricular (LV) dyssynchrony on clinical outcomes in patients with tetralogy of Fallot (TOF) is unknown. The aim of this study was to test the hypothesis that LV dyssynchrony assessed by cardiac magnetic resonance (CMR)-derived tissue tracking in patients with repaired TOF is associated with ventricular tachycardia (VT) and death. Included patients had repaired TOF and CMR data from 2000 and 2008. Patients (n = 13) had histories of death or sustained VT. Control subjects (n = 26), with no death or VT, were matched by age at CMR and type of last surgical procedure. Demographic, clinical, and electrocardiographic data were recorded. CMR short-axis cine data were analyzed by tracking the motion of the endocardial border using commercial software. LV dyssynchrony was quantified as the maximum difference in time to peak radial displacement, circumferential strain, and radial strain among the 6 ventricular segments and the standard deviation of the times to peak value. There were no differences between groups in clinical, electrocardiographic, or demographic characteristics. Among CMR parameters, right ventricular volumes were higher and ejection fractions lower in the patient group. Indexes of LV dyssynchrony were higher in the patient group (e.g., maximum time difference of circumferential strain 94 vs 46 ms, p <0.001; standard deviation of circumferential strain 37.8 vs 20.3 ms, p <0.01). In a multivariate model including LV synchrony variables, the best outcome discriminator was maximum time difference to peak circumferential strain (p <0.01). In conclusion, tissue tracking applied to CMR images identifies indexes of LV synchrony associated with death and VT in patients with repaired TOF.
Authors:
Marta Ortega; John K Triedman; Tal Geva; David M Harrild
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-15
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, Children's Hospital Boston, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
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