title: Impaired regional left ventricular strain after repair of tetralogy of Fallot.
abstract: OBJECTIVE
  To test the potential of magnetic resonance imaging (MRI) in early detection of left ventricular (LV) dysfunction in patients with pulmonary regurgitation and normal LV ejection fraction after repair of tetralogy of Fallot.
  
  
  METHODS
  Patients (n = 18) with repaired tetralogy of Fallot and pulmonary regurgitation were prospectively recruited. Healthy volunteers (n = 10) were used as control. Tagging MR images were acquired at the base, mid, and apical LV levels for assessing segmental rotation and circumferential strain. Cine MR images and velocity-encoded MR images were also acquired for assessment of biventricular volumes and biventricular function and pulmonary regurgitant fraction, respectively. Mean values were compared between groups using unpaired Student's t-test.
  
  
  RESULTS
  Patients presented with preserved global LV function (LVEF of 59 ± 5%). A significant decrease in LV peak circumferential strain was seen in patients compared with normal volunteers at the basilar (-15.6 ± 4.5% vs. -17.6 ± 4.4%; P < 0.01) and apical (-14.4± 6.1% vs. -17.3± 5.1%, P < 0.01) slices. LV peak rotation was also delayed in patients compared with volunteers at the basilar (6.1 ± 2.6° vs. 4.2 ± 0.6°; P < 0.01) and mid (8.0 ± 1.7° vs. 4.9 ± 1.0°; P < 0.01) slices.
  
  
  CONCLUSIONS
  MRI can detect early regional LV dysfunction in patients with preserved LVEF after repair of tetralogy of Fallot. MR may be a useful technique for guiding clinical decisions in these patients in order to prevent future global LV deterioration.
authors: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California 94143, USA. Karen.ordovas@radiology.ucsf.edu
authors: Karen G
authors: KG
authors: Ordovas
authors: Marcus
authors: M
authors: Carlsson
authors: Katy E
authors: KE
authors: Lease
authors: Elyse
authors: E
authors: Foster
authors: Alison K
authors: AK
authors: Meadows
authors: Alastair J
authors: AJ
authors: Martin
authors: Michael
authors: M
authors: Hope
authors: Loi
authors: L
authors: Do
authors: Charles B
authors: CB
authors: Higgins
authors: Maythem
authors: M
authors: Saeed
mesh_terms: D000328:Adult; D002309:Cardiology / Q000379:methods; D003287:Contrast Media / Q000494:pharmacology; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D003287:Contrast Media