title: Factors associated with biventricular dysfunction in patients with repaired tetralogy of Fallot.
abstract: BACKGROUND
  Impaired right ventricular (RV) mechanics is a common problem in patients after repair of tetralogy of Fallot (TOF). Moreover, also impaired left ventricular (LV) systolic function has been demonstrated in this population. There are no studies evaluating patients after TOF repair with impaired both RV and LV ejection fractions (RVEF, LVEF).
  
  
  OBJECTIVE
  We hypothesized that a considerable group of patients with repaired TOF would demonstrate both RV and LV systolic function impairment. Accordingly, the purpose of our study was to characterize patients with biventricular dysfunction after TOF repair.
  
  
  METHODS
  Consecutive patients with repaired TOF undergoing cardiac magnetic resonance (n=146, mean age 26.4±8.2 years, age range: 13.6-51.3 years, 60.3% males, 54 patients [37.0%] with early correction and 92 [63.0%] with late correction).
  
  
  RESULTS
  There were 31 patients (21.2% of the study population; 90.3% males) with biventricular dysfunction. Normal both RVEF and LVEF were observed in 65 individuals (44.5%). Neither the presence nor the extent of late gadolinium enhancement differed between patients with normal both RVEF and LVEF vs low both RVEF and LVEF. There were no differences in pulmonary regurgitation (PR) fraction, peak right ventricular outflow tract (RVOT) gradient, and the incidences of significant PR and RVOT obstruction between these groups (P=NS for all comparisons). Multivariate logistic regression revealed that the male sex and RVOT aneurysm/akinesia (only in patients repaired early) were associated with the presence of biventricular dysfunction.
  
  
  CONCLUSIONS
  In patients with repaired TOF, : Male sex and RVOT aneurysm/akinesia were independently associated with biventricular dysfunction. Impaired both RVEF and LVEF were common in patients with repaired TOF, with the vast majority of males.
authors: Instytut Kardiologii. mspiewak@ikard.pl.
authors: Mateusz
authors: M
authors: Spiewak
authors: Lukasz Andrzej
authors: LA
authors: Małek
authors: Joanna
authors: J
authors: Petryka
authors: Lukasz
authors: L
authors: Mazurkiewicz
authors: Magdalena
authors: M
authors: Marczak
authors: Elżbieta Katarzyna
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: Rużyłło