TY - JOUR
T1 - Prevalence of left ventricular systolic dysfunction in adults with repaired tetralogy of fallot
AU - Broberg, Craig S.
AU - Aboulhosn, Jamil
AU - Mongeon, Franois Pierre
AU - Kay, Joseph
AU - Valente, Anne Marie
AU - Khairy, Paul
AU - Earing, Michael G.
AU - Opotowsky, Alexander R.
AU - Lui, George
AU - Gersony, Deborah R.
AU - Cook, Stephen
AU - Ting, Jennifer Grando
AU - Webb, Gary
AU - Gurvitz, Michelle Z.
PY - 2011/4/15
Y1 - 2011/4/15
N2 - Left ventricular (LV) systolic dysfunction has been observed in patients with repaired tetralogy of Fallot (TOF), although its clinical associations are unknown. Adults with repaired TOF were identified from 11 adult congenital heart disease centers. Clinical history was reviewed. Patients with pulmonary atresia were excluded. Echocardiograms were reanalyzed to estimate LV ejection fraction. LV function was defined as normal (LV ejection fraction <55%) or mildly (45% to 54%), moderately (35% to 44%), or severely (<35%) decreased. Right ventricular (RV) and LV dimensions and Doppler parameters were remeasured. Function of all valves was qualitatively scored. Of 511 patients studied, LV systolic dysfunction was present in 107 (20.9%, 95% confidence interval 17.4 to 24.5). Specifically, 74 (14.4%) had mildly decreased and 33 (6.3%) had moderately to severely decreased systolic function. Presence of moderate to severe LV dysfunction was associated with male gender, LV enlargement, duration of shunt before repair, history of arrhythmia, QRS duration, implanted cardioverterdefibrillator, and moderate to severe RV dysfunction. Severity or duration of pulmonary regurgitation was not different. In conclusion, LV systolic dysfunction was found in 21% of adult patients with TOF and was associated with shunt duration, RV dysfunction, and arrhythmia.
AB - Left ventricular (LV) systolic dysfunction has been observed in patients with repaired tetralogy of Fallot (TOF), although its clinical associations are unknown. Adults with repaired TOF were identified from 11 adult congenital heart disease centers. Clinical history was reviewed. Patients with pulmonary atresia were excluded. Echocardiograms were reanalyzed to estimate LV ejection fraction. LV function was defined as normal (LV ejection fraction <55%) or mildly (45% to 54%), moderately (35% to 44%), or severely (<35%) decreased. Right ventricular (RV) and LV dimensions and Doppler parameters were remeasured. Function of all valves was qualitatively scored. Of 511 patients studied, LV systolic dysfunction was present in 107 (20.9%, 95% confidence interval 17.4 to 24.5). Specifically, 74 (14.4%) had mildly decreased and 33 (6.3%) had moderately to severely decreased systolic function. Presence of moderate to severe LV dysfunction was associated with male gender, LV enlargement, duration of shunt before repair, history of arrhythmia, QRS duration, implanted cardioverterdefibrillator, and moderate to severe RV dysfunction. Severity or duration of pulmonary regurgitation was not different. In conclusion, LV systolic dysfunction was found in 21% of adult patients with TOF and was associated with shunt duration, RV dysfunction, and arrhythmia.
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U2 - 10.1016/j.amjcard.2010.12.026
DO - 10.1016/j.amjcard.2010.12.026
M3 - Article
C2 - 21349477
AN - SCOPUS:79953236028
SN - 0002-9149
VL - 107
SP - 1215
EP - 1220
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 8
ER -