Departments of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates; Departments of Pediatric Cardiology, Skåne University Hospital, Lund University, Sweden.
Departments of Pediatric Cardiology, Skåne University Hospital, Lund University, Sweden.
Int J Cardiol. 2014 Mar 1;172(1):122-6. doi: 10.1016/j.ijcard.2013.12.188. Epub 2014 Jan 9.
To assess the possible effect of a stiff right ventricle on the coronary flow (CF) in patients with post-operative Tetralogy of Fallot (TOF).
Right ventricular restrictive physiology i.e. forward flow during atrial contraction (RVRP), is characteristic to many patients with post-operative TOF.
A total of 34 patients with TOF anatomically corrected through transatrial repair were included. Coronary flow parameters were registered with transthoracic Doppler echocardiography from posterior descending (PDCA) and left anterior descending (LAD) coronary arteries in the same patient in 24/34 (71%) patients. Twenty age-matched healthy children were used as controls. Cardiac magnetic resonance (CMR) imaging was used to detect myocardial fibrosis, RV volume, and RVRP.
The mean age at investigation was 10.2 ± 2.8 years. RV end diastolic and end systolic volumes indexed for BSA were larger in patients with RVRP (p=0.002 and 0.008 respectively). Peak flow velocity in diastole and flow velocity time integral was increased in patients compared to controls. They were increased in the LAD in patients with fibrosis of RV (n=11) compared to patients without fibrosis (n=9) (p=0.01 and 0.047 respectively). LAD coronary flow was especially increased in patients with RVRP (n=9) as compared with those without (n=11), (p=0.006).
Patients at mid-term followup after correction of TOF show increase of coronary flow. This increase is more pronounced in patients with fibrosis and RVRP of the RV.
评估右心室僵硬对法洛四联症（TOF）术后患者冠状动脉血流（CF）的可能影响。
右心室限制性生理学，即心房收缩期前向血流（RVRP），是许多术后 TOF 患者的特征。
共纳入 34 例经心房修复术解剖矫正的 TOF 患者。24/34（71%）名患者在同一患者的后降支（PDCA）和左前降支（LAD）冠状动脉中使用经胸多普勒超声心动图记录冠状动脉血流参数。20 名年龄匹配的健康儿童作为对照组。心脏磁共振（CMR）成像用于检测心肌纤维化、RV 容积和 RVRP。
研究时的平均年龄为 10.2±2.8 岁。有 RVRP 的患者 RV 舒张末期和收缩末期容积指数更大（p=0.002 和 0.008）。与对照组相比，患者的舒张期峰值流速和血流速度时间积分增加。与无纤维化的患者（n=9）相比，有 RV 纤维化的患者（n=11）的 LAD 血流增加（p=0.01 和 0.047）。与无 RVRP 的患者（n=11）相比，有 RVRP 的患者（n=9）的 LAD 冠状动脉血流增加更为明显（p=0.006）。
TOF 矫正后中期随访的患者显示冠状动脉血流增加。这种增加在 RV 纤维化和 RVRP 的患者中更为明显。
