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Biventricular Pressure-Volume Loop Assessment Before and After Pulmonary Valve Replacement in Tetralogy of Fallot

Binka, Edem ; Zhang, Jin ; Seemann, Felicia LU ; Jani, Vivek ; Barnes, Benjamin ; Gaur, Lasya ; Lima, Joao A.C. ; Ambale Venkatesh, Bharath ; Carlsson, Marcus LU and Kutty, Shelby (2022) In Journal of Thoracic Imaging 37(5). p.70-71
Abstract

Patients with tetralogy of Fallot (TOF) may undergo pulmonary valve replacement (PVR) after initial full repair. We investigated indices of biventricular function, work and efficiency of TOF patients' using noninvasive pressure-volume (PV) loop analysis on cardiovascular magnetic resonance (CMR) images and compared pre-and post PVR groups. Biventricular segmentations of steady state free precession CMR images were performed using custom validated software (Segment version 2.0 R7067). Brachial cuff pressure estimated left ventricular (LV) systolic pressure. Right ventricular (RV) inputs were obtained from pre-PVR cardiac catheterization data. Biventricular PV loops were then derived using a time-varying elastance model. Twenty seven... (More)

Patients with tetralogy of Fallot (TOF) may undergo pulmonary valve replacement (PVR) after initial full repair. We investigated indices of biventricular function, work and efficiency of TOF patients' using noninvasive pressure-volume (PV) loop analysis on cardiovascular magnetic resonance (CMR) images and compared pre-and post PVR groups. Biventricular segmentations of steady state free precession CMR images were performed using custom validated software (Segment version 2.0 R7067). Brachial cuff pressure estimated left ventricular (LV) systolic pressure. Right ventricular (RV) inputs were obtained from pre-PVR cardiac catheterization data. Biventricular PV loops were then derived using a time-varying elastance model. Twenty seven patients were studied: (22 pre-PVR, 5 post-PVR), mean age of 20±10.5 years and 83% male. RV stroke volume significantly differed before and after PVR (73.2±25 ml vs. 41±10 mL, P=0.01). RV stroke work (SW) and mean external power (MEP) were significantly less post-PVR, but there were no significant differences in the LV hemodynamic indices. TOF patients have reduced RV SW and MEP post-PVR suggesting improved hemodynamics. Noninvasive biventricular PV loop analysis shows potential for integration into standard CMR imaging of TOF and provides hemodynamic data that could influence management decisions.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardiovascular magnetic resonance, pressure-volume loops, tetralogy of Fallot
in
Journal of Thoracic Imaging
volume
37
issue
5
pages
70 - 71
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:35797659
  • scopus:85136551332
ISSN
0883-5993
DOI
10.1097/RTI.0000000000000665
language
English
LU publication?
yes
id
e07b5d05-2b04-4e68-9d9d-dbe265619e14
date added to LUP
2022-10-17 12:14:32
date last changed
2024-04-04 02:46:22
@article{e07b5d05-2b04-4e68-9d9d-dbe265619e14,
  abstract     = {{<p>Patients with tetralogy of Fallot (TOF) may undergo pulmonary valve replacement (PVR) after initial full repair. We investigated indices of biventricular function, work and efficiency of TOF patients' using noninvasive pressure-volume (PV) loop analysis on cardiovascular magnetic resonance (CMR) images and compared pre-and post PVR groups. Biventricular segmentations of steady state free precession CMR images were performed using custom validated software (Segment version 2.0 R7067). Brachial cuff pressure estimated left ventricular (LV) systolic pressure. Right ventricular (RV) inputs were obtained from pre-PVR cardiac catheterization data. Biventricular PV loops were then derived using a time-varying elastance model. Twenty seven patients were studied: (22 pre-PVR, 5 post-PVR), mean age of 20±10.5 years and 83% male. RV stroke volume significantly differed before and after PVR (73.2±25 ml vs. 41±10 mL, P=0.01). RV stroke work (SW) and mean external power (MEP) were significantly less post-PVR, but there were no significant differences in the LV hemodynamic indices. TOF patients have reduced RV SW and MEP post-PVR suggesting improved hemodynamics. Noninvasive biventricular PV loop analysis shows potential for integration into standard CMR imaging of TOF and provides hemodynamic data that could influence management decisions.</p>}},
  author       = {{Binka, Edem and Zhang, Jin and Seemann, Felicia and Jani, Vivek and Barnes, Benjamin and Gaur, Lasya and Lima, Joao A.C. and Ambale Venkatesh, Bharath and Carlsson, Marcus and Kutty, Shelby}},
  issn         = {{0883-5993}},
  keywords     = {{cardiovascular magnetic resonance; pressure-volume loops; tetralogy of Fallot}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{5}},
  pages        = {{70--71}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Thoracic Imaging}},
  title        = {{Biventricular Pressure-Volume Loop Assessment Before and After Pulmonary Valve Replacement in Tetralogy of Fallot}},
  url          = {{http://dx.doi.org/10.1097/RTI.0000000000000665}},
  doi          = {{10.1097/RTI.0000000000000665}},
  volume       = {{37}},
  year         = {{2022}},
}