Quantitative assessment of pulmonary regurgitation in patients with and without right ventricular tract obstruction.
BACKGROUND
There are concerns whether there is a difference in clinical utility of pulmonary regurgitation (PR) fraction (PRF) and PR volume (PRV) in subgroups of patients with isolated PR and individuals with combined PR and right ventricular outflow tract obstruction (RVOTO). The aim of the study was to compare PRF and PRV in patients with or without RVOTO.


RESULTS
82 consecutive patients after repair of tetralogy of Fallot (TOF) who underwent cardiovascular magnetic resonance and echocardiography were studied. There was no difference in PRF between patients with moderate and severe right ventricular (RV) dilatation (32±13% vs. 37±12%; p=0.18). Significant difference in PRV was observed between these groups (23±10 ml/m2 vs. 31±12 ml/m2, respectively; p=0.02). PRV had better ability than PRF in identification of severe RV dilatation, both in group with RVOTO [area under the curve (AUC) 0.82 vs. 0.72, p=0.005] and in patients without RVOTO (AUC 0.83 vs. 0.77, p=0.04). A strong correlation was seen between PRF and PRV both in patients with and without RVOTO [r=0.93, p<0.0001 and r=0.92, p<0.0001, respectively]. In both subgroups high variability of PRF was found in subjects with similar degree of PRV.


CONCLUSIONS
PRV shows better ability than PRF in evaluating influence of PR on RV in patients after TOF repair, both in population with and without concomitant RVOTO.
Spiewak
Mateusz
M
Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland. mspiewak@ikard.pl
Biernacka
Elżbieta K
EK
Małek
Łukasz A
ŁA
Miśko
Jolanta
J
Kowalski
Mirosław
M
Miłosz
Barbara
B
Petryka
Joanna
J
Zabicka
Magdalena
M
Rużyłło
Witold
W
D000328:Adult; D000704:Analysis of Variance; D019540:Area Under Curve; D006348:Cardiac Surgical Procedures; D016009:Chi-Square Distribution; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011665:Pulmonary Valve Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011666:Pulmonary Valve Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery