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Progressive right ventricular outflow tract fibrosis after repair of tetralogy of Fallot

Published online by Cambridge University Press:  28 July 2020

Gauri R. Karur ,
Wadi Mawad Open the ORCID record for Wadi Mawad [Opens in a new window]  and
Lars Grosse-Wortmann
Gauri R. Karur
Affiliation:
Toronto Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada
Wadi Mawad
Affiliation:
Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Department of Paediatrics, Montreal Children’s Hospital, McGill University Health Centre, Montreal, Quebec, Canada
Lars Grosse-Wortmann*
Affiliation:
Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Department of Pediatrics, Doernbecher Children’s Hospital, Oregon Health and Science University, Portland, OR, USA
*
Address for Correspondence: Lars Grosse-Wortmann, Doernbecher Children’s Hospital, 700 SW Campus Drive, Portland, OR97239, USA. Tel: +1 505-494-0207; Fax: +1 503-494-2824. Email: grossewo@ohsu.edu
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Abstract

Objectives:

The objective of this study was to determine the evolution of fibrosis over time and its association with clinical status.

Methods:

Children with repaired tetralogy of Fallot who had undergone at least two cardiac magnetic resonance examinations including T1 mapping at least 1 year apart were included.

Results:

Thirty-seven patients (12.7 ± 2.6 years, 61% male) were included. Right ventricular free wall T1 increased (913 ± 208 versus 1023 ± 220 ms; p = 0.02). Baseline cardiac magnetic resonance parameters did not predict a change in imaging markers or exercise tolerance. The right ventricular free wall per cent change correlated with left ventricular T1% change (r = 0.51, p = 0.001) and right ventricular mass Z-score change (r = 0.51, p = 0.001). T1 in patients with late gadolinium enhancement did not differ from the rest.

Conclusion:

Increasing right ventricular free wall T1 indicates possible progressive fibrotic remodelling in the right ventricular outflow tract in this pilot study in children and adolescents with repaired tetralogy of Fallot. The value of T1 mapping both at baseline and during serial assessments will need to be investigated in larger cohorts with longer follow-up.

Keywords

Tetralogy of Fallotdiffuse myocardial fibrosisT1 mappingcardiac MRI
Type
Brief Report
Information
Cardiology in the Young , Volume 30 , Issue 9 , September 2020 , pp. 1366 - 1367
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

Gauri R. Karur and Wadi Mawad have contributed equally to this manuscript.

References

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