title: The impact of preexisting myocardial remodeling on ventricular function early after tetralogy of Fallot repair.
abstract: BACKGROUND
  Twenty-three patients (median age 23 months) who underwent Fallot's tetralogy repair were investigated prospectively to detect a possible association between histopathologic myocardial remodeling and echocardiographic findings of systolic or diastolic ventricular dysfunction.
  
  
  METHODS
  Intraoperatively resected infundibular bands and subendocardial biopsy samples from the right ventricle (RV) and left ventricle were obtained for histopathologic evaluation. Tissue Doppler echocardiographic interrogation of the ventricles was performed before surgery and in the postoperative period.
  
  
  RESULTS
  Histopathologic data revealed hypertrophy of the RV cardiomyocytes and increased interstitial collagen in both ventricles. Mean values of RV isovolumic acceleration decreased significantly at the third evaluation compared with the preoperative values (P = .006). RV myocardial fibrosis greater than 8.3% was associated with a probability of altered E' of at least 0.7 (odds ratio = 2.31).
  
  
  CONCLUSIONS
  Preoperative histologic myocardial remodeling influenced the postoperative RV function in this group of patients with late repair. Further studies are necessary to evaluate the myocardium in younger patients and to define its influence in the long-term follow-up.
authors.affiliation: Medical School, Health and Biological Sciences Center, University of Mato Grosso, Brazil.
authors.forename: Maria Cecília Knoll
authors.initials: MC
authors.lastname: Farah
authors.forename: Cláudia Regina Pinheiro
authors.initials: CR
authors.lastname: Castro
authors.forename: Valéria de Melo
authors.initials: Vde M
authors.lastname: Moreira
authors.forename: Maria Angélica
authors.initials: MA
authors.lastname: Binotto
authors.forename: Vitor Coimbra
authors.initials: VC
authors.lastname: Guerra
authors.forename: Arlindo de Almeida
authors.initials: Ade A
authors.lastname: Riso
authors.forename: Miguel Barbero
authors.initials: MB
authors.lastname: Marcial
authors.forename: Antonio Augusto
authors.initials: AA
authors.lastname: Lopes
authors.forename: Wilson
authors.initials: W
authors.lastname: Mathias
authors.forename: Vera Demarchi
authors.initials: VD
authors.lastname: Aiello
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003094:Collagen / Q000648:ultrastructure; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D004730:Endothelium, Vascular / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D032383:Myocytes, Cardiac / Q000648:ultrastructure; D011446:Prospective Studies; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D020257:Ventricular Remodeling
chemical_list: D003094:Collagen