title: Relation of right ventricular mass and volume to functional health status in repaired tetralogy of Fallot.
abstract: After repair of tetralogy of Fallot, right ventricular (RV) mass and mass:volume ratio may reflect RV remodeling and adverse outcomes. This study aimed to evaluate the relation of RV mass to functional health status and subsequent adverse RV remodeling and to determine whether RV mass measurement in systole could improve reproducibility. In 53 patients with tetralogy of Fallot (median 29 years old) who previously underwent cardiovascular magnetic resonance and completed the Short Form 36, version 2 (Optum, Eden Prairie, MN), short-axis images were analyzed for RV end-diastolic volume and diastolic and systolic mass, indexed to body surface area. The most recent subsequent cardiovascular magnetic resonance study (before pulmonary valve or conduit replacement) was evaluated for change in RV end-diastolic volume and ejection fraction. Diastolic indexed mass ≥37.3 g/m(2) (odds ratio 7.6, p = 0.02) predicted decreased general health scores. In patients with normal RV ejection fraction, indexed mass correlated with Physical Component Summary and general health scores. RV diastolic mass:volume ratio >0.2 had a strong association with subsequent increase in RV end-diastolic volume (odds ratio 26.1, p = 0.002). Systolic RV mass measurement had excellent correlation with diastolic measurement (r = 0.97, p <0.0001), but did not improve intraobserver or interobserver variability. In conclusion, RV mass relates to functional health status and adverse RV remodeling and can be measured with good reproducibility. RV mass should be routinely evaluated in this population and is best measured in diastole; further study is necessary to evaluate longitudinal changes in functional health status and RV parameters.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan; Section of Pediatric Radiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan. Electronic address: jimmyl@umich.edu.
authors.forename: Jimmy C
authors.initials: JC
authors.lastname: Lu
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Christensen
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan.
authors.forename: Sunkyung
authors.initials: S
authors.lastname: Yu
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Donohue
authors.affiliation: Section of Pediatric Radiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Maryam
authors.initials: M
authors.lastname: Ghadimi Mahani
authors.affiliation: Division of Cardiothoracic Radiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Prachi P
authors.initials: PP
authors.lastname: Agarwal
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan; Section of Pediatric Radiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Dorfman
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures; D002306:Cardiac Volume / Q000502:physiology*; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013771:Tetralogy of Fallot / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult