title: Pressure half-time predicts hemodynamically significant pulmonary regurgitation in adult patients with repaired tetralogy of fallot.
abstract: Pulmonary regurgitation (PR) is associated with adverse outcomes late after tetralogy of Fallot repair. Accurate assessment of PR in these patients is, therefore, fundamental to their clinical treatment; however, accurate ultrasound markers of severity are as yet poorly defined. This is a prospective study of 34 adult patients with repaired tetralogy of Fallot. Cardiac magnetic resonance imaging was used to assess the PR fraction and its hemodynamic significance on the right ventricular volumes. Regurgitant fractions >/= 20% were associated with significant increases in right ventricular end-diastolic volumes. Echocardiographic continuous wave Doppler profiles of the PR jet were used to calculate pressure half-time. Pulmonary pressure half-time < 100 milliseconds was found to be a good indicator of hemodynamically significant regurgitation. This measure is highly reproducible and easily accessible.
authors.affiliation: Department of Diagnostic Imaging, University Health Network, Toronto, Ontario, Canada.
authors.forename: Candice K
authors.initials: CK
authors.lastname: Silversides
authors.forename: Gruschen R
authors.initials: GR
authors.lastname: Veldtman
authors.forename: Jane
authors.initials: J
authors.lastname: Crossin
authors.forename: Naeem
authors.initials: N
authors.lastname: Merchant
authors.forename: Gary D
authors.initials: GD
authors.lastname: Webb
authors.forename: Brian W
authors.initials: BW
authors.lastname: McCrindle
authors.forename: Samuel C
authors.initials: SC
authors.lastname: Siu
authors.forename: Judith
authors.initials: J
authors.lastname: Therrien
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000453:epidemiology / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009864:Ontario; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011664:Pulmonary Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D011665:Pulmonary Valve Insufficiency / Q000453:epidemiology / Q000503:physiopathology*; D011859:Radiography; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013318:Stroke Volume / Q000502:physiology; D013771:Tetralogy of Fallot / Q000453:epidemiology / Q000503:physiopathology*; D014664:Vasodilation / Q000502:physiology