Turbulent kinetic energy in the right ventricle [Elektronisk resurs] Potential MR marker for risk stratification of adults with repaired Tetralogy of Fallot

• Purpose: To assess right ventricular (RV) turbulent kinetic energy (TKE) in patients with repaired Tetralogy of Fallot (rToF) and a spectrum of pulmonary regurgitation (PR), as well as to investigate the relationship between these 4D flow markers and RV remodeling. Materials and Methods: Seventeen patients with rToF and 10 healthy controls were included in the study. Patients were divided into two groups based on PR fraction: one lower PR fraction group (11%) and one higher PR fraction group (>11%). Field strength/sequences: 3D cine phase contrast (4D flow), 2D cine phase contrast (2D flow), and balanced steady-state free precession (bSSFP) at 1.5T. Assessment: The RV volume was segmented in the morphologic short-axis images and TKE parameters were computed inside the segmented RV volume throughout diastole. Statistical tests: One-way analysis of variance with Bonferroni post-hoc test; unpaired t-test; Pearson correlation coefficients; simple and stepwise multiple regression models; intraclass correlation coefficient (ICC). Results: The higher PR fraction group had more remodeled RVs (140 6 25 vs. 107 6 22 [lower PR fraction, P < 0.01] and 93 6 15 ml/m2[healthy, P < 0.001] for RV end-diastolic volume index [RVEDVI]) and higher TKE values (5.95 6 3.15 vs. 2.23 6 0.81 [lower PR fraction, P < 0.01] and 1.91 6 0.78 mJ [healthy, P < 0.001] for Peak Total RV TKE). Multiple regression analysis between RVEDVI and 4D/2D flow parameters showed that Peak Total RV TKE was the strongest predictor of RVEDVI (R25 0.47, P 5 0.002). Conclusion: The 4D flow-specific TKE markers showed a slightly stronger association with RV remodeling than conventional 2D flow PR parameters. These results suggest novel hemodynamic aspects of PR in the development of late complications after ToF repair. 

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Medical and Health Sciences  (hsv)

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Radiology, Nuclear Medicine and Medical Imaging  (hsv)

Medicin och hälsovetenskap  (hsv)

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Cardiac and Cardiovascular Systems  (hsv)

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Medical and Health Sciences  (hsv)

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Medicin och hälsovetenskap  (hsv)

Klinisk medicin  (hsv)

Anestesi och intensivvård  (hsv)

Engineering and Technology  (hsv)

Medical Engineering  (hsv)

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Genre

government publication  (marcgt)

Indexterm och SAB-rubrik

4D flow

MRI

Turbulence

Tetralogy of Fallot

Turbulent kinetic energy