Open AccessLeft Ventricular Torsion Obtained Using Equilibrated Warping in Patients with Repaired Tetralogy of Fallot
Author(s) -
Daniel A. Castellanos,
Kateřina Škardová,
Abhijit Bhattaru,
Ezgi Berberoğlu,
Gerald Greil,
Animesh Tandon,
Jeanne Dillenbeck,
Barbara Burkhardt,
Tarique Hussain,
Martin Genet,
Radomír Chabiniok
Publication year - 2021
Publication title -
pediatric cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.646
H-Index - 71
eISSN - 1432-1971
pISSN - 0172-0643
DOI - 10.1007/s00246-021-02608-y
Subject(s) - tetralogy of fallot , medicine , intraclass correlation , image warping , cardiac surgery , torsion (gastropod) , cardiology , reproducibility , ejection fraction , vascular surgery , heart failure , surgery , heart disease , mathematics , artificial intelligence , computer science , clinical psychology , statistics , psychometrics
Patients after surgical repair of Tetralogy of Fallot (rTOF) may suffer a decrease in left ventricular (LV) function. The aim of our study is to evaluate a novel method of assessing LV torsion in patients with rTOF, as an early indicator of systolic LV dysfunction. Motion tracking based on image registration regularized by the equilibrium gap principle, known as equilibrated warping, was employed to assess LV torsion. Seventy-six cases of rTOF and ten normal controls were included. The group of controls was assessed for reproducibility using both equilibrated warping and standard clinical tissue tracking software (CVI42, version 5.10.1, Calgary, Canada). Patients were dichotomized into two groups: normal vs. loss of torsion. Torsion by equilibrated warping was successfully obtained in 68 of 76 (89%) patients and 9 of 10 (90%) controls. For equilibrated warping, the intra- and interobserver coefficients of variation were 0.095 and 0.117, respectively, compared to 0.260 and 0.831 for tissue tracking by standard clinical software. The intra- and inter-observer intraclass correlation coefficients for equilibrated warping were 0.862 and 0.831, respectively, compared to 0.992 and 0.648 for tissue tracking. Loss of torsion was noted in 32 of the 68 (47%) patients with rTOF. There was no difference in LV or RV volumes or ejection fraction between these groups. The assessment of LV torsion by equilibrated warping is feasible and shows good reliability. Loss of torsion is common in patients with rTOF and its robust assessment might contribute into uncovering heart failure in an earlier stage.