Le Cœur en Sabot: shape associations with adverse events in repaired tetralogy of Fallot
Abstract Background Maladaptive remodelling mechanisms occur in patients with repaired tetralogy of Fallot (rToF) resulting in a cycle of metabolic and structural changes. Biventricular shape analysis may indicate mechanisms associated with adverse events independent of pulmonary regurgitant volume...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12968-022-00877-x |
| _version_ | 1827270808043520000 |
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| author | Anna Mîra Pablo Lamata Kuberan Pushparajah Georgina Abraham Charlène A. Mauger Andrew D. McCulloch Jeffrey H. Omens Malenka M. Bissell Zach Blair Tyler Huffaker Animesh Tandon Sandy Engelhardt Sven Koehler Thomas Pickardt Philipp Beerbaum Samir Sarikouch Heiner Latus Gerald Greil Alistair A. Young Tarique Hussain |
| author_facet | Anna Mîra Pablo Lamata Kuberan Pushparajah Georgina Abraham Charlène A. Mauger Andrew D. McCulloch Jeffrey H. Omens Malenka M. Bissell Zach Blair Tyler Huffaker Animesh Tandon Sandy Engelhardt Sven Koehler Thomas Pickardt Philipp Beerbaum Samir Sarikouch Heiner Latus Gerald Greil Alistair A. Young Tarique Hussain |
| author_sort | Anna Mîra |
| collection | DOAJ |
| description | Abstract Background Maladaptive remodelling mechanisms occur in patients with repaired tetralogy of Fallot (rToF) resulting in a cycle of metabolic and structural changes. Biventricular shape analysis may indicate mechanisms associated with adverse events independent of pulmonary regurgitant volume index (PRVI). We aimed to determine novel remodelling patterns associated with adverse events in patients with rToF using shape and function analysis. Methods Biventricular shape and function were studied in 192 patients with rToF (median time from TOF repair to baseline evaluation 13.5 years). Linear discriminant analysis (LDA) and principal component analysis (PCA) were used to identify shape differences between patients with and without adverse events. Adverse events included death, arrhythmias, and cardiac arrest with median follow-up of 10 years. Results LDA and PCA showed that shape characteristics pertaining to adverse events included a more circular left ventricle (LV) (decreased eccentricity), dilated (increased sphericity) LV base, increased right ventricular (RV) apical sphericity, and decreased RV basal sphericity. Multivariate LDA showed that the optimal discriminative model included only RV apical ejection fraction and one PCA mode associated with a more circular and dilated LV base (AUC = 0.77). PRVI did not add value, and shape changes associated with increased PRVI were not predictive of adverse outcomes. Conclusion Pathological remodelling patterns in patients with rToF are significantly associated with adverse events, independent of PRVI. Mechanisms related to incident events include LV basal dilation with a reduced RV apical ejection fraction. |
| first_indexed | 2024-04-11T21:34:49Z |
| format | Article |
| id | doaj.art-46946418b9d843c8970348b2e2cee889 |
| institution | Directory Open Access Journal |
| issn | 1532-429X |
| language | English |
| last_indexed | 2025-03-22T05:27:18Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj.art-46946418b9d843c8970348b2e2cee8892024-04-27T00:15:01ZengElsevierJournal of Cardiovascular Magnetic Resonance1532-429X2022-08-0124111210.1186/s12968-022-00877-xLe Cœur en Sabot: shape associations with adverse events in repaired tetralogy of FallotAnna Mîra0Pablo Lamata1Kuberan Pushparajah2Georgina Abraham3Charlène A. Mauger4Andrew D. McCulloch5Jeffrey H. Omens6Malenka M. Bissell7Zach Blair8Tyler Huffaker9Animesh Tandon10Sandy Engelhardt11Sven Koehler12Thomas Pickardt13Philipp Beerbaum14Samir Sarikouch15Heiner Latus16Gerald Greil17Alistair A. Young18Tarique Hussain19Department of Biomedical Engineering, King’s College LondonDepartment of Biomedical Engineering, King’s College LondonDepartment of Biomedical Engineering, King’s College LondonDepartment of Biomedical Engineering, King’s College LondonDepartment of Anatomy and Medical Imaging, University of AucklandDepartment of Bioengineering, University of California San DiegoDepartment of Bioengineering, University of California San DiegoLeeds Institute of Cardiovascular and Metabolic Medicine, University of LeedsDepartment of Pediatrics, Division of Pediatric Cardiology, University of Texas Southwestern Medical CenterDepartment of Pediatrics, Division of Pediatric Cardiology, University of Texas Southwestern Medical CenterDepartment of Pediatrics, Division of Pediatric Cardiology, University of Texas Southwestern Medical CenterDepartment of Internal Medicine III, Group Artificial Intelligence in Cardiovascular Medicine, Heidelberg University HospitalDepartment of Internal Medicine III, Group Artificial Intelligence in Cardiovascular Medicine, Heidelberg University HospitalGerman Competence Network for Congenital Heart Defects, DZHK (German Centre for Cardiovascular Research)German Competence Network for Congenital Heart Defects, DZHK (German Centre for Cardiovascular Research)German Competence Network for Congenital Heart Defects, DZHK (German Centre for Cardiovascular Research)Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre MunichDepartment of Pediatrics, Division of Pediatric Cardiology, University of Texas Southwestern Medical CenterDepartment of Biomedical Engineering, King’s College LondonDepartment of Pediatrics, Division of Pediatric Cardiology, University of Texas Southwestern Medical CenterAbstract Background Maladaptive remodelling mechanisms occur in patients with repaired tetralogy of Fallot (rToF) resulting in a cycle of metabolic and structural changes. Biventricular shape analysis may indicate mechanisms associated with adverse events independent of pulmonary regurgitant volume index (PRVI). We aimed to determine novel remodelling patterns associated with adverse events in patients with rToF using shape and function analysis. Methods Biventricular shape and function were studied in 192 patients with rToF (median time from TOF repair to baseline evaluation 13.5 years). Linear discriminant analysis (LDA) and principal component analysis (PCA) were used to identify shape differences between patients with and without adverse events. Adverse events included death, arrhythmias, and cardiac arrest with median follow-up of 10 years. Results LDA and PCA showed that shape characteristics pertaining to adverse events included a more circular left ventricle (LV) (decreased eccentricity), dilated (increased sphericity) LV base, increased right ventricular (RV) apical sphericity, and decreased RV basal sphericity. Multivariate LDA showed that the optimal discriminative model included only RV apical ejection fraction and one PCA mode associated with a more circular and dilated LV base (AUC = 0.77). PRVI did not add value, and shape changes associated with increased PRVI were not predictive of adverse outcomes. Conclusion Pathological remodelling patterns in patients with rToF are significantly associated with adverse events, independent of PRVI. Mechanisms related to incident events include LV basal dilation with a reduced RV apical ejection fraction.https://doi.org/10.1186/s12968-022-00877-xTetralogy of FallotBiventricular shapeMagnetic resonance imagingBiomarker |
| spellingShingle | Anna Mîra Pablo Lamata Kuberan Pushparajah Georgina Abraham Charlène A. Mauger Andrew D. McCulloch Jeffrey H. Omens Malenka M. Bissell Zach Blair Tyler Huffaker Animesh Tandon Sandy Engelhardt Sven Koehler Thomas Pickardt Philipp Beerbaum Samir Sarikouch Heiner Latus Gerald Greil Alistair A. Young Tarique Hussain Le Cœur en Sabot: shape associations with adverse events in repaired tetralogy of Fallot Journal of Cardiovascular Magnetic Resonance Tetralogy of Fallot Biventricular shape Magnetic resonance imaging Biomarker |
| title | Le Cœur en Sabot: shape associations with adverse events in repaired tetralogy of Fallot |
| title_full | Le Cœur en Sabot: shape associations with adverse events in repaired tetralogy of Fallot |
| title_fullStr | Le Cœur en Sabot: shape associations with adverse events in repaired tetralogy of Fallot |
| title_full_unstemmed | Le Cœur en Sabot: shape associations with adverse events in repaired tetralogy of Fallot |
| title_short | Le Cœur en Sabot: shape associations with adverse events in repaired tetralogy of Fallot |
| title_sort | le coeur en sabot shape associations with adverse events in repaired tetralogy of fallot |
| topic | Tetralogy of Fallot Biventricular shape Magnetic resonance imaging Biomarker |
| url | https://doi.org/10.1186/s12968-022-00877-x |
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