Relationship between Pulmonary Regurgitation and Ventriculo–Arterial Interactions in Patients with Post-Early Repair of Tetralogy of Fallot: Insights from Wave-Intensity Analysis
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...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/20/6186 |
| _version_ | 1797431508314619904 |
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| author | Nikesh Arya Silvia Schievano Massimo Caputo Andrew M. Taylor Giovanni Biglino |
| author_facet | Nikesh Arya Silvia Schievano Massimo Caputo Andrew M. Taylor Giovanni Biglino |
| author_sort | Nikesh Arya |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T09:46:05Z |
| format | Article |
| id | doaj.art-bd41cc430d424bc3b4b647280c007d9d |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T09:46:05Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-bd41cc430d424bc3b4b647280c007d9d2023-12-02T00:34:02ZengMDPI AGJournal of Clinical Medicine2077-03832022-10-011120618610.3390/jcm11206186Relationship between Pulmonary Regurgitation and Ventriculo–Arterial Interactions in Patients with Post-Early Repair of Tetralogy of Fallot: Insights from Wave-Intensity AnalysisNikesh Arya0Silvia Schievano1Massimo Caputo2Andrew M. Taylor3Giovanni Biglino4Faculty of Mathematical and Physical Sciences, University College London, London WC1E 6BT, UKInstitute of Cardiovascular Science, University College London, London WC1E 6BT, UKBristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol BS8 1TH, UKInstitute of Cardiovascular Science, University College London, London WC1E 6BT, UKBristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol BS8 1TH, UKThis 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.https://www.mdpi.com/2077-0383/11/20/6186tetralogy of fallotcongenital heart diseaseleft ventricleaortawave-intensity analysismagnetic resonance imaging |
| spellingShingle | Nikesh Arya Silvia Schievano Massimo Caputo Andrew M. Taylor Giovanni Biglino Relationship between Pulmonary Regurgitation and Ventriculo–Arterial Interactions in Patients with Post-Early Repair of Tetralogy of Fallot: Insights from Wave-Intensity Analysis Journal of Clinical Medicine tetralogy of fallot congenital heart disease left ventricle aorta wave-intensity analysis magnetic resonance imaging |
| title | Relationship between Pulmonary Regurgitation and Ventriculo–Arterial Interactions in Patients with Post-Early Repair of Tetralogy of Fallot: Insights from Wave-Intensity Analysis |
| title_full | Relationship between Pulmonary Regurgitation and Ventriculo–Arterial Interactions in Patients with Post-Early Repair of Tetralogy of Fallot: Insights from Wave-Intensity Analysis |
| title_fullStr | Relationship between Pulmonary Regurgitation and Ventriculo–Arterial Interactions in Patients with Post-Early Repair of Tetralogy of Fallot: Insights from Wave-Intensity Analysis |
| title_full_unstemmed | Relationship between Pulmonary Regurgitation and Ventriculo–Arterial Interactions in Patients with Post-Early Repair of Tetralogy of Fallot: Insights from Wave-Intensity Analysis |
| title_short | Relationship between Pulmonary Regurgitation and Ventriculo–Arterial Interactions in Patients with Post-Early Repair of Tetralogy of Fallot: Insights from Wave-Intensity Analysis |
| title_sort | relationship between pulmonary regurgitation and ventriculo arterial interactions in patients with post early repair of tetralogy of fallot insights from wave intensity analysis |
| topic | tetralogy of fallot congenital heart disease left ventricle aorta wave-intensity analysis magnetic resonance imaging |
| url | https://www.mdpi.com/2077-0383/11/20/6186 |
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