title: Repaired tetralogy of Fallot: ratio of right ventricular volume to left ventricular volume as a marker of right ventricular dilatation.
abstract: OBJECTIVE
  To compare indexed right ventricular (RV) end-diastolic volume (RVEDVi) and the ratio of RV volume to left ventricular (LV) volume (RV/LV ratio) in prediction of significant pulmonary regurgitation (PR) after tetralogy of Fallot (TOF) repair and to assess sex differences in the RV/LV ratio.
  
  
  METHODS
  The ethics committee approved this retrospective single-center study, and patients or their parents or guardians signed written informed consent. RVEDVi, RV/LV ratio, and PR were measured with the use of magnetic resonance imaging in 155 consecutive patients with repaired TOF (mean age, 29.2 years±10.9 [standard deviation]; 98 [63.2%] male and 57 [36.8%] female patients). PR fraction of 20% or greater was considered significant. The capability of the RVEDVi and that of the RV/LV ratio for prediction of significant PR were compared by using logistic regression analysis and receiver operating characteristic curve analysis.
  
  
  RESULTS
  RVEDVi was significantly higher in male (162.8 mL/m2±50.4) than in female (138.2 mL/m2±37.5) patients (P=.001). Conversely, the RV/LV ratio was similar in both sexes (1.82±0.56 [male] vs 1.69±0.46 [female], P=.13) both in the entire cohort and after excluding patients with significant (≥30 mm Hg) RV outflow tract gradient and/or other residual hemodynamic abnormalities (P=.63). Receiver operating characteristic analysis revealed better discrimination of significant (≥20%) from insignificant (<20%) PR with the use of the RV/LV ratio than with RVEDVi (area under the receiver operating characteristic curve, 0.937 [model 4] vs 0.849 [model 1], P=.01). In multivariate analysis, the only independent predictor of PR fraction was the RV/LV ratio.
  
  
  CONCLUSIONS
  The RV/LV ratio is more accurate than the RVEDVi in differentiation of significant from insignificant PR. After TOF repair, female and male patients have similar RV/LV ratios despite significant differences in RVEDVi between the sexes.
authors: Department of Coronary Artery Disease and Structural Heart Diseases, Cardiac Magnetic Resonance Unit, Institute of Cardiology, ul Alpejska 42, 04-628 Warsaw, Poland. mspiewak@ikard.pl
authors: Mateusz
authors: M
authors: Spiewak
authors: Łukasz A
authors: ŁA
authors: Małek
authors: Joanna
authors: J
authors: Petryka
authors: Łukasz
authors: Ł
authors: Mazurkiewicz
authors: Konrad
authors: K
authors: Werys
authors: Elzbieta K
authors: EK
authors: Biernacka
authors: Mirosław
authors: M
authors: Kowalski
authors: Piotr
authors: P
authors: Hoffman
authors: Marcin
authors: M
authors: Demkow
authors: Jolanta
authors: J
authors: Miśko
authors: Witold
authors: W
authors: Ruzyłło
mesh_terms: D000328:Adult; D055424:Cardiac-Gated Imaging Techniques; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011665:Pulmonary Valve Insufficiency / Q000503:physiopathology*; D012372:ROC Curve; D012189:Retrospective Studies; D012737:Sex Factors; D013771:Tetralogy of Fallot / Q000503:physiopathology* / Q000601:surgery*; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology*