title: Right Atrial Volume is Increased in Corrected Tetralogy of Fallot and Correlates with the Incidence of Supraventricular Arrhythmia: A CMR Study.
abstract: The aim of this study was to evaluate right atrial (RA) volume in corrected Tetralogy of Fallot (cTOF) and assess its correlation with the occurrence of supraventricular (SV) arrhythmia. Cardiac magnetic resonance imaging (CMR) and 24-h Holter were performed in n = 67 consecutive cTOF patients (age 30 ± 11.3 years). The CMR protocol included standard HASTE, SSFP cine, and blood flow measurements. Correlations between arrhythmia in ECG, heart volume, and functional parameters were investigated by negative binominal regression. Patients' characteristics (mean ± SD) included mean RA volume of 49 ± 19 ml/m(2) (HASTE sequence), mean right ventricular (RV) end-diastolic volume of 98 ± 27 ml/m(2), mean pulmonary valve regurgitation fraction (PR) of 21 ± 19 %, BMI of 25 kg/m(2), and heart rate of 75/min. Twenty-eight out of 67 patients experienced SV arrhythmia including SV couplets or bigeminus or longer non-sustained SV tachycardia (SVT) episodes. RA volume index was identified as an independent risk factor for different degrees of SV arrhythmia (SV couplets/bigeminus p < 0.001, SVT p < 0.001). Further risk factors for SV arrhythmia were male gender (p = 0.023) and decreased left ventricular (LV) ejection fraction (EF) (LV EF p < 0.001). RA volume is increased in adult patients with cTOF with larger RA volumes relating to higher incidence of SV arrhythmia. SV arrhythmia also appeared more often in male patients and those with decreased LV EF. Risk stratification according to these parameters could help to optimize early prevention and adjusted individual therapy to improve patient outcome and quality of life.
authors: Institute for Diagnostic and Interventional Radiology, Heart Center, University Medical Center, Georg-August-University Göttingen, Göttingen, Germany.
authors: Jan M
authors: JM
authors: Sohns
authors: Christina
authors: C
authors: Rosenberg
authors: Antonia
authors: A
authors: Zapf
authors: Christina
authors: C
authors: Unterberg-Buchwald
authors: Wieland
authors: W
authors: Staab
authors: Andreas
authors: A
authors: Schuster
authors: Johannes T
authors: JT
authors: Kowallick
authors: Olga
authors: O
authors: Hösch
authors: Thuy-Trang
authors: TT
authors: Nguyen
authors: Martin
authors: M
authors: Fasshauer
authors: Thomas
authors: T
authors: Paul
authors: Joachim
authors: J
authors: Lotz
authors: Michael
authors: M
authors: Steinmetz
mesh_terms: D000293:Adolescent; D000328:Adult; D002306:Cardiac Volume; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000033:anatomy & histology*; D006339:Heart Rate; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011665:Pulmonary Valve Insufficiency / Q000503:physiopathology; D013318:Stroke Volume; D013617:Tachycardia, Supraventricular / Q000453:epidemiology / Q000503:physiopathology*; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*; D016278:Ventricular Function, Right; D055815:Young Adult