Left and right ventricular diastolic function in adults with surgically repaired tetralogy of Fallot: a multi-institutional study.
BACKGROUND
Our purpose was to assess the prevalence and clinical implications of left ventricular (LV) and right ventricular (RV) diastolic dysfunction (DD) in patients with repaired tetralogy of Fallot (TOF).


METHODS
Adults with repaired TOF at 11 North American congenital heart disease centres were included. Of 556 patients analyzed, 325 had sufficient Doppler data to evaluate for LV DD, defined as mitral lateral e' < 10 cm/s and E/e' ratio > 9. Abnormal RV diastolic function was defined as tricuspid E/A ratio of 0.8 to 2.1 with E/e' ratio > 6 or a tricuspid ratio E/A > 2.1 with a deceleration time < 120 milliseconds, and 105 patients were found to have sufficient Doppler data.


RESULTS
Abnormal LV diastolic Doppler indices were prevalent in 13.8% and associated with hypertension, dyslipidemia, 3 or more cardiac operations, and a history of ventricular tachycardia. Abnormal RV indices were prevalent in 52.4% and associated with hypertension, dyslipidemia, diabetes mellitus, and 3 or more cardiac operations. Ventricular tachycardia was more common in those with abnormal RV diastolic function.


CONCLUSIONS
Further prospective studies are needed to evaluate these associations with DD and the impact of treatment risk factors on diastolic function and arrhythmia burden.
Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA 90095, USA. jaboulhosn@mednet.ucla.edu
Jamil A
JA
Aboulhosn
Gentian
G
Lluri
Michelle Z
MZ
Gurvitz
Paul
P
Khairy
François-Pierre
FP
Mongeon
Joseph
J
Kay
Anne Marie
AM
Valente
Michael G
MG
Earing
Alexander R
AR
Opotowsky
George
G
Lui
Deborah R
DR
Gersony
Stephen
S
Cook
John
J
Child
Jennifer
J
Ting
Gary
G
Webb
Michael
M
Landzberg
Craig S
CS
Broberg
D000328:Adult; D003430:Cross-Sectional Studies; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015995:Prevalence; D012189:Retrospective Studies; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055815:Young Adult