Elhadi H Aburawi1, Peter Munkhammar2, Marcus Carlsson3, Mohamed El-Sadig4, Erkki Pesonen2. 1. Departments of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates; Departments of Pediatric Cardiology, Skåne University Hospital, Lund University, Sweden. Electronic address: e.aburawi@uaeu.ac.ae. 2. Departments of Pediatric Cardiology, Skåne University Hospital, Lund University, Sweden. 3. Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund University, Sweden. 4. Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
Abstract
OBJECTIVES: To assess the possible effect of a stiff right ventricle on the coronary flow (CF) in patients with post-operative Tetralogy of Fallot (TOF). BACKGROUND: Right ventricular restrictive physiology i.e. forward flow during atrial contraction (RVRP), is characteristic to many patients with post-operative TOF. METHODS: A total of 34 patients with TOF anatomically corrected through transatrial repair were included. Coronary flow parameters were registered with transthoracic Doppler echocardiography from posterior descending (PDCA) and left anterior descending (LAD) coronary arteries in the same patient in 24/34 (71%) patients. Twenty age-matched healthy children were used as controls. Cardiac magnetic resonance (CMR) imaging was used to detect myocardial fibrosis, RV volume, and RVRP. RESULTS: The mean age at investigation was 10.2 ± 2.8 years. RV end diastolic and end systolic volumes indexed for BSA were larger in patients with RVRP (p=0.002 and 0.008 respectively). Peak flow velocity in diastole and flow velocity time integral was increased in patients compared to controls. They were increased in the LAD in patients with fibrosis of RV (n=11) compared to patients without fibrosis (n=9) (p=0.01 and 0.047 respectively). LAD coronary flow was especially increased in patients with RVRP (n=9) as compared with those without (n=11), (p=0.006). CONCLUSIONS: Patients at mid-term followup after correction of TOF show increase of coronary flow. This increase is more pronounced in patients with fibrosis and RVRP of the RV.
OBJECTIVES: To assess the possible effect of a stiff right ventricle on the coronary flow (CF) in patients with post-operative Tetralogy of Fallot (TOF). BACKGROUND: Right ventricular restrictive physiology i.e. forward flow during atrial contraction (RVRP), is characteristic to many patients with post-operative TOF. METHODS: A total of 34 patients with TOF anatomically corrected through transatrial repair were included. Coronary flow parameters were registered with transthoracic Doppler echocardiography from posterior descending (PDCA) and left anterior descending (LAD) coronary arteries in the same patient in 24/34 (71%) patients. Twenty age-matched healthy children were used as controls. Cardiac magnetic resonance (CMR) imaging was used to detect myocardial fibrosis, RV volume, and RVRP. RESULTS: The mean age at investigation was 10.2 ± 2.8 years. RV end diastolic and end systolic volumes indexed for BSA were larger in patients with RVRP (p=0.002 and 0.008 respectively). Peak flow velocity in diastole and flow velocity time integral was increased in patients compared to controls. They were increased in the LAD in patients with fibrosis of RV (n=11) compared to patients without fibrosis (n=9) (p=0.01 and 0.047 respectively). LAD coronary flow was especially increased in patients with RVRP (n=9) as compared with those without (n=11), (p=0.006). CONCLUSIONS:Patients at mid-term followup after correction of TOF show increase of coronary flow. This increase is more pronounced in patients with fibrosis and RVRP of the RV.
Authors: Jef Van den Eynde; Emilie Derdeyn; Art Schuermans; Pushpa Shivaram; Werner Budts; David A Danford; Shelby Kutty Journal: J Am Heart Assoc Date: 2022-03-18 Impact factor: 6.106
Authors: Claire E Raphael; Jennifer Keegan; Kim H Parker; Robin Simpson; Julian Collinson; Vass Vassiliou; Ricardo Wage; Peter Drivas; Stephen Strain; Robert Cooper; Ranil de Silva; Rod H Stables; Carlo Di Mario; Michael Frenneaux; Dudley J Pennell; Justin E Davies; Alun D Hughes; David Firmin; Sanjay K Prasad Journal: J Cardiovasc Magn Reson Date: 2016-12-09 Impact factor: 5.364