Predicting Survival in Repaired Tetralogy of Fallot: A Lesion-Specific and Personalized Approach.
CMR
late gadolinium enhancement
risk stratification
sudden cardiac death
tetralogy of Fallot
ventricular tachycardia
Journal
JACC. Cardiovascular imaging
ISSN: 1876-7591
Titre abrégé: JACC Cardiovasc Imaging
Pays: United States
ID NLM: 101467978
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
06
01
2021
revised:
20
07
2021
accepted:
28
07
2021
pubmed:
18
10
2021
medline:
22
2
2022
entrez:
17
10
2021
Statut:
ppublish
Résumé
This study sought to identify patients with repaired tetralogy of Fallot (rTOF) at high risk of death and malignant ventricular arrhythmia (VA). To date there is no robust risk stratification scheme to predict outcomes in adults with rTOF. Consecutive patients were prospectively recruited for late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) to define right and left ventricular (RV, LV) fibrosis in addition to proven risk markers. The primary endpoint was all-cause mortality. Of the 550 patients (median age 32 years, 56% male), 27 died (mean follow-up 6.4 ± 5.8; total 3,512 years). Mortality was independently predicted by RVLGE extent, presence of LVLGE, RV ejection fraction ≤47%, LV ejection fraction ≤55%, B-type natriuretic peptide ≥127 ng/L, peak exercise oxygen uptake (V0 We present a score integrating multiple appropriately weighted risk factors to identify the subgroup of patients with rTOF who are at high annual risk of death who may benefit from targeted therapy.
Sections du résumé
OBJECTIVES
This study sought to identify patients with repaired tetralogy of Fallot (rTOF) at high risk of death and malignant ventricular arrhythmia (VA).
BACKGROUND
To date there is no robust risk stratification scheme to predict outcomes in adults with rTOF.
METHODS
Consecutive patients were prospectively recruited for late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) to define right and left ventricular (RV, LV) fibrosis in addition to proven risk markers.
RESULTS
The primary endpoint was all-cause mortality. Of the 550 patients (median age 32 years, 56% male), 27 died (mean follow-up 6.4 ± 5.8; total 3,512 years). Mortality was independently predicted by RVLGE extent, presence of LVLGE, RV ejection fraction ≤47%, LV ejection fraction ≤55%, B-type natriuretic peptide ≥127 ng/L, peak exercise oxygen uptake (V0
CONCLUSIONS
We present a score integrating multiple appropriately weighted risk factors to identify the subgroup of patients with rTOF who are at high annual risk of death who may benefit from targeted therapy.
Identifiants
pubmed: 34656466
pii: S1936-878X(21)00631-8
doi: 10.1016/j.jcmg.2021.07.026
pmc: PMC8821017
pii:
doi:
Substances chimiques
Contrast Media
0
Gadolinium
AU0V1LM3JT
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
257-268Subventions
Organisme : British Heart Foundation
ID : FS/11/38/28864
Pays : United Kingdom
Organisme : British Heart Foundation
ID : FS/13/76/30477
Pays : United Kingdom
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Funding Support and Author Disclosures This work was supported by the British Heart Foundation (FS/11/38/28864), Drs Babu-Narayan and Heng were funded by the British Heart Foundation. Prof Dudley Pennell is a consultant to Siemens. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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