Oregon Health and Science University, Portland, Oregon.
Am J Cardiol. 2011 Apr 15;107(8):1215-20. doi: 10.1016/j.amjcard.2010.12.026. Epub 2011 Feb 23.
Left ventricular (LV) systolic dysfunction has been observed in patients with repaired tetralogy of Fallot (TOF), although its clinical associations are unknown. Adults with repaired TOF were identified from 11 adult congenital heart disease centers. Clinical history was reviewed. Patients with pulmonary atresia were excluded. Echocardiograms were reanalyzed to estimate LV ejection fraction. LV function was defined as normal (LV ejection fraction ≥ 55%) or mildly (45% to 54%), moderately (35% to 44%), or severely (< 35%) decreased. Right ventricular (RV) and LV dimensions and Doppler parameters were remeasured. Function of all valves was qualitatively scored. Of 511 patients studied, LV systolic dysfunction was present in 107 (20.9%, 95% confidence interval 17.4 to 24.5). Specifically, 74 (14.4%) had mildly decreased and 33 (6.3%) had moderately to severely decreased systolic function. Presence of moderate to severe LV dysfunction was associated with male gender, LV enlargement, duration of shunt before repair, history of arrhythmia, QRS duration, implanted cardioverter-defibrillator, and moderate to severe RV dysfunction. Severity or duration of pulmonary regurgitation was not different. In conclusion, LV systolic dysfunction was found in 21% of adult patients with TOF and was associated with shunt duration, RV dysfunction, and arrhythmia.
左心室（LV）收缩功能障碍已在法洛四联症（TOF）修复患者中观察到，尽管其临床相关性尚不清楚。从 11 个成人先天性心脏病中心确定了修复 TOF 的成年人患者。回顾临床病史。排除肺动脉闭锁患者。重新分析超声心动图以估计 LV 射血分数。LV 功能定义为正常（LV 射血分数≥55%）或轻度（45%至 54%）、中度（35%至 44%）或重度（<35%）降低。重新测量右心室（RV）和 LV 尺寸和多普勒参数。所有瓣膜的功能均进行定性评分。在研究的 511 例患者中，107 例（20.9%，95%置信区间 17.4%至 24.5%）存在 LV 收缩功能障碍。具体而言，74 例（14.4%）存在轻度降低，33 例（6.3%）存在中度至重度收缩功能障碍。中度至重度 LV 功能障碍的存在与男性、LV 增大、修复前分流持续时间、心律失常史、QRS 持续时间、植入式心脏复律除颤器和中度至重度 RV 功能障碍相关。严重程度或肺动脉瓣反流持续时间无差异。总之，TOF 成年患者中有 21%存在 LV 收缩功能障碍，与分流持续时间、RV 功能障碍和心律失常有关。
