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163 ± 25 ml/m 2 to 183 ± 29 ml/m 2 ); these parameters did not change in subgroup I. Biventricular function remained stable during follow-up in all subgroups. Biventricular contractile reserve was preserved in all patients. VO2 max. decreased during follow-up, particularly in subgroup II, but this was not statistically significant. After PVR, RV volumes and PR decreased significantly; RVEF and LV contractile reserve increased. A lower RV contractile reserve at baseline correlated with a larger RVEDV at follow-up and with an interstudy decrease in VO2 max. NT-proBNP levels were significantly higher than in healthy controls (at follow-up 13 ± 10 pmol/l (patients) vs. 4 ± 2 pmol/l (controls)) but did not change over time and were not different between the subgroups. Conclusion RV volumes and PR percentage increased significantly over time, but only in TOF patients who had a RVEDV ≥ 150 ml/m 2 at baseline. Exercise capacity tended to decrease at 5-year follow-up, but biventricular function, biventricular contractile reserve, and NT-proBNP remained stable, irrespective of baseline MRI measurements. Baseline RV MR stress measurements correlated with important follow-up measurements of RV size and exercise capacity. Stress MRI showed clinically relevant changes after PVR. Stress imaging might be of additional value in the follow-up of TOF patients. In our patients, NT-proBNP provided limited additional information during follow-up.

journal of cardiovascular magnetic resonance

Serial follow-up of biventricular function, exercise capacity and NT-proBNP measurements in repaired tetralogy of Fallot: is there a role for MR stress imaging?