Department of Coronary Artery Disease and Structural Heart Diseases, Cardiac Magnetic Resonance Unit, Institute of Cardiology, ul Alpejska 42, 04-628 Warsaw, Poland.
Radiology. 2012 Oct;265(1):78-86. doi: 10.1148/radiol.12120051. Epub 2012 Jul 6.
To compare indexed right ventricular (RV) end-diastolic volume (RVEDVi) and the ratio of RV volume to left ventricular (LV) volume (RV/LV ratio) in prediction of significant pulmonary regurgitation (PR) after tetralogy of Fallot (TOF) repair and to assess sex differences in the RV/LV ratio.
The ethics committee approved this retrospective single-center study, and patients or their parents or guardians signed written informed consent. RVEDVi, RV/LV ratio, and PR were measured with the use of magnetic resonance imaging in 155 consecutive patients with repaired TOF (mean age, 29.2 years±10.9 [standard deviation]; 98 [63.2%] male and 57 [36.8%] female patients). PR fraction of 20% or greater was considered significant. The capability of the RVEDVi and that of the RV/LV ratio for prediction of significant PR were compared by using logistic regression analysis and receiver operating characteristic curve analysis.
RVEDVi was significantly higher in male (162.8 mL/m2±50.4) than in female (138.2 mL/m2±37.5) patients (P=.001). Conversely, the RV/LV ratio was similar in both sexes (1.82±0.56 [male] vs 1.69±0.46 [female], P=.13) both in the entire cohort and after excluding patients with significant (≥30 mm Hg) RV outflow tract gradient and/or other residual hemodynamic abnormalities (P=.63). Receiver operating characteristic analysis revealed better discrimination of significant (≥20%) from insignificant (<20%) PR with the use of the RV/LV ratio than with RVEDVi (area under the receiver operating characteristic curve, 0.937 [model 4] vs 0.849 [model 1], P=.01). In multivariate analysis, the only independent predictor of PR fraction was the RV/LV ratio.
The RV/LV ratio is more accurate than the RVEDVi in differentiation of significant from insignificant PR. After TOF repair, female and male patients have similar RV/LV ratios despite significant differences in RVEDVi between the sexes.
比较索引右心室（RV）舒张末期容积（RVEDVi）和 RV 与左心室（LV）容积比（RV/LV 比）在法洛四联症（TOF）修复后预测重度肺动脉瓣反流（PR）中的作用，并评估 RV/LV 比的性别差异。
该研究为回顾性单中心研究，经伦理委员会批准，患者或其父母或监护人签署了书面知情同意书。使用磁共振成像测量 155 例连续修复的 TOF 患者的 RVEDVi、RV/LV 比和 PR（平均年龄 29.2 岁±10.9[标准差]；男性 98 例[63.2%]，女性 57 例[36.8%]）。PR 分数≥20% 被认为是显著的。使用逻辑回归分析和接收者操作特征曲线分析比较了 RVEDVi 和 RV/LV 比预测重度 PR 的能力。
男性（162.8 毫升/平方米±50.4）RVEDVi 明显高于女性（138.2 毫升/平方米±37.5）（P=.001）。相反，在整个队列和排除有显著（≥30mmHg）RV 流出道梯度和/或其他残余血流动力学异常的患者后，RV/LV 比在男女两性均相似（1.82±0.56[男性]与 1.69±0.46[女性]，P=.13）（P=.63）。接收者操作特征分析显示，与 RVEDVi 相比，使用 RV/LV 比可更好地区分重度（≥20%）与轻度（<20%）PR（接收者操作特征曲线下面积，0.937[模型 4]与 0.849[模型 1]，P=.01）。多变量分析显示，PR 分数的唯一独立预测因子是 RV/LV 比。
与 RVEDVi 相比，RV/LV 比在区分重度与轻度 PR 方面更准确。在 TOF 修复后，尽管男性和女性 RVEDVi 存在显著差异，但 RV/LV 比在两性之间相似。
