title: Factors associated with right ventricular dilatation and dysfunction in patients with chronic pulmonary regurgitation after repair of tetralogy of Fallot: analysis of magnetic resonance imaging data from 218 patients.
abstract: OBJECTIVE
  The aim of the present study was to identify the factors associated with right ventricular (RV) dilatation and dysfunction in patients with chronic pulmonary regurgitation (PR) after repair of tetralogy of Fallot.
  
  
  METHODS
  From April 2002 to June 2013, 218 patients with repaired tetralogy of Fallot underwent magnetic resonance imaging; 165 (76%) underwent transannular repair and 36 (17%) underwent nontransannular repair. Linear regression analyses were used to identify the predictors for RV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), and ejection fraction.
  
  
  RESULTS
  On univariable analysis, male sex, ventricular septal defect (VSD) closure through the right ventricle, larger pulmonary artery index, and greater PR fraction were associated with greater RV volume indexes. Multivariable analyses identified male sex (β = 17.55, P < .001 for RV EDVI; β = 14.08, P = .001 for RV ESVI), VSD closure through RV (β = 8.49, P = .048 for RV ESVI), longer interval since repair (β = 1.29, P = .014 for RV EDVI), and greater PR fraction (β = 1.92, P < .001 for RV EDVI; β = 1.38, P < .001 for RV ESVI) as independent predictors for greater RV volume indexes. On univariable analysis, male sex, VSD closure through the right ventricle, and greater PR fraction were associated with a lower RV ejection fraction. Multivariable analysis identified male sex (β = -3.10, P = .018), VSD closure through the right ventricle (β = -3.05, P = .020), and greater PR fraction (β = -0.27, P < .001) as independent predictors for a lower RV ejection fraction.
  
  
  CONCLUSIONS
  Male sex, VSD closure through the right ventricle, longer interval since repair, and greater PR fraction were independent predictors of RV dilatation after tetralogy of Fallot repair. Male sex, VSD closure through the right ventricle, and greater PR fraction were also independent predictors of RV dysfunction.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea. Electronic address: tscheul@hanmail.net.
authors.forename: Cheul
authors.initials: C
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Chang-Ha
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Jae Gun
authors.initials: JG
authors.lastname: Kwak
authors.affiliation: Department of Pediatric Cardiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Pediatric Cardiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Woo-Sup
authors.initials: WS
authors.lastname: Shim
authors.affiliation: Department of Pediatric Cardiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Sang Yun
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Pediatric Cardiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: So-Ick
authors.initials: SI
authors.lastname: Jang
authors.affiliation: Department of Pediatric Cardiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Su-Jin
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Department of Radiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Yang Min
authors.initials: YM
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004108:Dilatation, Pathologic; D005260:Female; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011665:Pulmonary Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013318:Stroke Volume; D013771:Tetralogy of Fallot / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016278:Ventricular Function, Right; D055815:Young Adult