title: Prevalence of left ventricular systolic dysfunction in adults with repaired tetralogy of fallot.
abstract: Left ventricular (LV) systolic dysfunction has been observed in patients with repaired tetralogy of Fallot (TOF), although its clinical associations are unknown. Adults with repaired TOF were identified from 11 adult congenital heart disease centers. Clinical history was reviewed. Patients with pulmonary atresia were excluded. Echocardiograms were reanalyzed to estimate LV ejection fraction. LV function was defined as normal (LV ejection fraction ≥ 55%) or mildly (45% to 54%), moderately (35% to 44%), or severely (< 35%) decreased. Right ventricular (RV) and LV dimensions and Doppler parameters were remeasured. Function of all valves was qualitatively scored. Of 511 patients studied, LV systolic dysfunction was present in 107 (20.9%, 95% confidence interval 17.4 to 24.5). Specifically, 74 (14.4%) had mildly decreased and 33 (6.3%) had moderately to severely decreased systolic function. Presence of moderate to severe LV dysfunction was associated with male gender, LV enlargement, duration of shunt before repair, history of arrhythmia, QRS duration, implanted cardioverter-defibrillator, and moderate to severe RV dysfunction. Severity or duration of pulmonary regurgitation was not different. In conclusion, LV systolic dysfunction was found in 21% of adult patients with TOF and was associated with shunt duration, RV dysfunction, and arrhythmia.
authors.affiliation: Oregon Health and Science University, Portland, Oregon. brobergc@ohsu.edu
authors.forename: Craig S
authors.initials: CS
authors.lastname: Broberg
authors.forename: Jamil
authors.initials: J
authors.lastname: Aboulhosn
authors.forename: François-Pierre
authors.initials: FP
authors.lastname: Mongeon
authors.forename: Joseph
authors.initials: J
authors.lastname: Kay
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Valente
authors.forename: Paul
authors.initials: P
authors.lastname: Khairy
authors.forename: Michael G
authors.initials: MG
authors.lastname: Earing
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Opotowsky
authors.forename: George
authors.initials: G
authors.lastname: Lui
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Gersony
authors.forename: Stephen
authors.initials: S
authors.lastname: Cook
authors.forename: Jennifer Grando
authors.initials: JG
authors.lastname: Ting
authors.forename: Gary
authors.initials: G
authors.lastname: Webb
authors.forename: Michelle Z
authors.initials: MZ
authors.lastname: Gurvitz
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D013771:Tetralogy of Fallot / Q000150:complications* / Q000601:surgery; D014481:United States / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology* / Q000209:etiology