Morphometrics predicts the differential regurgitant fraction in bilateral pulmonary arteries of patients with repaired tetralogy of fallot

被引:0
作者
Hui-Chung Teng
Yi-Chun Chen
Yung-Lin Chen
Ken-Pen Weng
Jun-Yen Pan
Ming-Hua Chang
Hsiu-Wen Cheng
Ming-Ting Wu
机构
[1] Kaohsiung Veterans General Hospital,Department of Radiology
[2] Mei Ho University,Department of Nursing
[3] National Yang Ming Chiao Tung University,School of Medicine, College of Medicine
[4] Kaohsiung Veterans General Hospital,Congenital Structural Heart Disease Center, Department of Pediatrics
[5] Kaohsiung Veterans General Hospital,Division of Cardiovascular Surgery, Department of Surgery
[6] National Yang Ming Chiao Tung University,Institute of Clinical Medicine
来源
The International Journal of Cardiovascular Imaging | 2024年 / 40卷
关键词
Differential regurgitant fraction; Pulmonary regurgitation; Tetralogy of fallot; Cardiovascular magnetic resonance; Pulmonary artery angle;
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摘要
In patients with repaired tetralogy of Fallot (rTOF), the regurgitant fraction (RF) in left pulmonary artery (LPA) and right pulmonary artery (RPA) is usually unequal. The morphometrics may play a crucial role in this RF discrepancy. Cardiovascular MR of 79 rTOF patients and 20 healthy controls were retrospectively enrolled. Forty-four from the 79 patients were matched in age, sex and body surface area to the 20 controls and were investigated for: (1) phase-contrast flow of main pulmonary artery (MPA), LPA, and RPA; (2) vascular angles: the angles between the thoracic anterior–posterior line (TAPL) with MPA (θM–AP), MPA with RPA (θM–R), and MPA with LPA (θM–L); (3) cardiac angle, the angle between TAPL and the interventricular septum; (4) area ratio of bilateral lung and hemithorax regions. Compared with the 20 controls, the 44 rTOF patients exhibited wider θM–AP, sharper θM–L angle, and a smaller θM–L/θM–R ratio. In the 79 rTOF patients, LPA showed lower forward, backward, and net flow, and greater RF as compared with RPA. Multivariate analysis showed that the RF of LPA was negatively associated with the θM–L/θM–R ratio and the age at surgery (R2 = 0.255). Conversely, the RF of RPA was negatively associated with the left lung/left hemithorax area ratio and cross-sectional area (CSA) of LPA, and positively associated with CSA of RPA and MPA (R2 = 0.366). In rTOF patients, the RF of LPA is more severe than that of RPA, which may be related to the vascular morphometrics. Different morphometric parameters are independently associated with the RF of LPA or RPA, which may offer potential insights for surgical strategies.
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页码:655 / 664
页数:9
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