Relationship between Pulmonary Regurgitation and Ventriculo-Arterial Interactions in Patients with Post-Early Repair of Tetralogy of Fallot: Insights from Wave-Intensity Analysis.
Nikesh AryaSilvia SchievanoMassimo CaputoAndrew M TaylorGiovanni BiglinoPublished in: Journal of clinical medicine (2022)
This study aimed to investigate the effect of pulmonary regurgitation (PR) on left ventricular ventriculo-arterial (VA) coupling in patients with repaired tetralogy of Fallot (ToF). It was hypothesised that increasing PR severity results in a smaller forward compression wave (FCW) peak in the aortic wave intensity, because of right-to-left ventricular interactions. The use of cardiovascular magnetic resonance (CMR)-derived wave-intensity analysis provided a non-invasive comparison between patients with varying PR degrees. A total of n = 201 patients were studied and both hemodynamic and wave-intensity data were compared. Wave-intensity peaks and areas of the forward compression and forward expansion waves were calculated as surrogates of ventricular function. Any extent of PR resulted in a significant reduction in the FCW peak. A correlation was found between aortic distensibility and the FCW peak, suggesting unfavourable (VA) coupling in patients that also present stiffer ascending aortas. Data suggest that VA coupling is affected by increased impedance.
Keyphrases
- left ventricular
- magnetic resonance
- end stage renal disease
- high intensity
- aortic valve
- ejection fraction
- aortic stenosis
- heart failure
- newly diagnosed
- chronic kidney disease
- prognostic factors
- acute myocardial infarction
- hypertrophic cardiomyopathy
- pulmonary artery
- patient reported outcomes
- mitral valve
- coronary artery disease
- room temperature
- electronic health record
- big data
- left atrial
- ms ms
- cardiac resynchronization therapy
- acute coronary syndrome
- contrast enhanced
- atrial fibrillation
- deep learning