title: The Cardiovascular Effects of Obesity on Ventricular Function and Mass in Patients after Tetralogy of Fallot Repair.
abstract: OBJECTIVE
  To determine the cardiovascular effects of obesity on patients with tetralogy of Fallot (TOF) repair.
  
  
  METHODS
  Ventricular performance measures were compared between obese (body mass index [BMI] ≥95%), overweight (85% ≤BMI <95%), and normal weight subjects (BMI <85%) in a retrospective review of patients with TOF who underwent cardiac magnetic resonance from 2005-2010. Significance was P < .05.
  
  
  RESULTS
  Of 260 consecutive patients with TOF, 32 were obese (12.3%), 48 were overweight (18.5%), and 180 were normal weight (69.2%). Biventricular mass was increased in obese compared with normal weight patients with right ventricular mass more affected than left ventricular mass. Obese patients demonstrated decreased biventricular end-diastolic volume (EDV) and stroke volume (SV) when indexed to body surface area (BSA) with an increased heart rate when compared with normal weight patients; cardiac index, ejection fraction, and pulmonary regurgitation fraction were similar. When indexed to ideal BSA, biventricular EDV and SV were similar. EDV and SV for overweight patients were nearly identical to normal weight patients with ventricular mass in between the other 2 groups.
  
  
  CONCLUSIONS
  Approximately 12% of patients after TOF repair referred for cardiac magnetic resonance in a tertiary referral center are obese with increased biventricular mass. Obese patients and normal weight patients have similar cardiac indices, however, when indexed to actual BSA, obese patients demonstrate decreased EDV and SV with increased heart rate and similar cardiac indices. When indexed to ideal BSA, no differences in biventricular volumes were noted.
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA; Department of Radiology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA. Electronic address: fogel@email.chop.edu.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Fogel
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Pawlowski
authors.affiliation: Department of Radiology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA.
authors.forename: Marc S
authors.initials: MS
authors.lastname: Keller
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA.
authors.forename: Meryl S
authors.initials: MS
authors.lastname: Cohen
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Goldmuntz
authors.affiliation: Division of Cardiothoracic Anesthesiology, Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA.
authors.forename: Laura
authors.initials: L
authors.lastname: Diaz
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA.
authors.forename: Christine
authors.initials: C
authors.lastname: Li
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA; Department of Radiology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA.
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Whitehead
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA; Department of Radiology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology*; D013771:Tetralogy of Fallot / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D016276:Ventricular Function / Q000502:physiology