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Biventricular Shape Modes Associated with Clinical History and Pulmonary Regurgitation in Repaired Tetralogy of Fallot
Author(s) -
Govil Sachin,
Mauger Charlene,
Hegde Sanjeet,
Perry James,
Suinesiaputra Avan,
Omens Jeff,
McCulloch Andrew,
Young Alistair
Publication year - 2020
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2020.34.s1.04305
Subject(s) - tetralogy of fallot , medicine , cardiology , pulmonary valve , pulmonary valve insufficiency , pulmonary regurgitation , ventricular outflow tract , pulmonary hypertension , pulmonary artery , ventricular remodeling , regurgitation (circulation) , heart failure , heart disease
Surgical repair of tetralogy of Fallot (ToF) often involves damage to the right ventricular (RV) outflow tract typically resulting in pulmonary valve impairment and subsequent pulmonary regurgitation. Residual pulmonary regurgitation leads to progressive RV remodeling in the form of RV dilation and apical bulging, and plays an important role in long‐term outcomes. Patients with severe pulmonary regurgitation and RV decompensation undergo pulmonary valve replacement (PVR) to reduce the risk of arrhythmia, heart failure, and sudden death. However, the clinical decision on whether and when to perform PVR remains unclear. We sought to quantify biventricular shape modes associated with clinical history and pulmonary regurgitation prior to valve replacement using a biventricular geometric atlas constructed using principle component analysis. In this cross‐sectional retrospective study, biventricular shape models were customized using cardiovascular magnetic resonance images from 97 repaired ToF patients. Patients were divided into two groups: those that subsequently had PVR and those that did not. Regression and clustering techniques were used to quantify shape variations associated with type of surgical repair, time following surgical repair, time leading up to valve replacement, and pulmonary regurgitant volumes. Principal components of biventricular shape variation were associated with RV dilation and apical bulging, overall size and sphericity, and valve plane orientation. Biventricular shape modes were quantified using statistical shape modeling techniques and are correlated with clinical history and pulmonary regurgitation. Support or Funding Information Funding was provided by the National Institutes of Health 1R01HL121754. SG acknowledges National Institutes of Health NHLBI 1T32HL105373. CM acknowledges New Zealand Heart Foundation Grant 1695. AY acknowledges Health Research Council Grant 17/234.