title: Right Ventricular Mass is Associated with Exercise Capacity in Adults with Repaired Tetralogy of Fallot.
abstract: The relationship between exercise capacity and right ventricular (RV) structure and function in adult repaired tetralogy of Fallot (TOF) is poorly understood. We therefore aimed to examine the relationships between cardiac MRI and cardiopulmonary exercise test variables in adult repaired TOF patients. In particular, we sought to determine the role of RV mass in determining exercise capacity. Eighty-two adult repaired TOF patients (age at evaluation 26 ± 10 years; mean age at repair 2.5 ± 2.8 years; 23.3 ± 7.9 years since repair; 53 males) (including nine patients with tetralogy-type pulmonary atresia with ventricular septal defect) were prospectively recruited to undergo cardiac MRI and cardiopulmonary exercise testing. As expected, these repaired TOF patients had RV dilatation (indexed RV end-diastolic volume: 153 ± 43.9 mL/m(2)), moderate-severe pulmonary regurgitation (pulmonary regurgitant fraction: 33 ± 14 %) and preserved left (LV ejection fraction: 59 ± 8 %) and RV systolic function (RV ejection fraction: 51 ± 7 %). Exercise capacity was near-normal (peak work: 88 ± 17 % predicted; peak oxygen consumption: 84 ± 17 % predicted). Peak work exhibited a significant positive correlation with RV mass in univariate analysis (r = 0.45, p < 0.001) and (independent of other cardiac MRI variables) in multivariate analyses. For each 10 g higher RV mass, peak work was 8 W higher. Peak work exhibits a significant positive correlation with RV mass, independent of other cardiac MRI variables. RV mass measured on cardiac MRI may provide a novel marker of clinical progress in adult patients with repaired TOF.
authors: Faculty of Medicine, The University of Sydney, Sydney, Australia, shamus.omeagher@sswahs.nsw.gov.au.
authors: Shamus
authors: S
authors: O'Meagher
authors: Martin
authors: M
authors: Seneviratne
authors: Michael R
authors: MR
authors: Skilton
authors: Phillip A
authors: PA
authors: Munoz
authors: Peter J
authors: PJ
authors: Robinson
authors: Nathan
authors: N
authors: Malitz
authors: David J
authors: DJ
authors: Tanous
authors: David S
authors: DS
authors: Celermajer
authors: Rajesh
authors: R
authors: Puranik
mesh_terms: D000328:Adult; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011184:Postoperative Period; D013771:Tetralogy of Fallot / Q000601:surgery*; D016896:Treatment Outcome; D016278:Ventricular Function, Right / Q000502:physiology; D055815:Young Adult