Tetralogy of Fallot: impact of the excursion of the interventricular septum on left ventricular systolic function and XXXX after surgical repair.

@entity1 @entity82 @entity215 @entity22286 @entity2287
PURPOSE: To quantify the excursion of interventricular septum (IVS) in @entity1 after repair of @entity215 ( @entity215 ), a marker of interventricular interaction, and assess its association with left ventricular (LV) ejection fraction, LV septal wall thickening, and LV @entity82 . MATERIALS AND METHODS: The HIPAA-compliant protocol received institutional board review approval. IVS excursion was measured at cardiovascular magnetic resonance (MR) imaging in 82 @entity1 after repair of @entity215 and in 10 healthy volunteers. IVS excursion was correlated with LV ejection fraction, LV septal wall thickening, and LV delayed @entity2287 enhancement. Independent predictors of reduced LV ejection fraction were identified, including significant univariable predictors with use of a multivariable logistic regression model. RESULTS: IVS excursion was greater in @entity1 than in healthy volunteers (5.3 mm    3.1 vs 1.2 mm    0.4, P < .01). @entity1 (n = 68) with abnormal excursion of the IVS had reduced LV ejection fraction (57%    7 vs 61%    4, P < .01) and reduced LV septal wall thickening (24%    10 vs 29%    5, P = .01) compared with @entity1 with normal IVS excursion. @entity22286 (odds ratio = 1.27 per millimeter, P = .03) and right ventricular (RV) ejection fraction (odds ratio = 0.92 per percentage, P = .031) were independent predictors of reduced LV ejection fraction (<55%). Among the 44 @entity1 with delayed enhancement images, those with abnormal excursion of the IVS had higher LV delayed enhancement scores (median, 1.5 [interquartile range, 0-2] vs 0 [interquartile range, 0-0]; P < .01] than @entity1 with normal IVS excursion. Notably, in all but one @entity1 the delayed enhancement was located at the RV-LV hinge points. CONCLUSION: Abnormal IVS excursion after repair of @entity215 is associated with reduced global and septal LV systolic function and LV @entity82 at the RV-LV hinge points, suggesting a mechanism of adverse interventricular interaction.
