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Heart 1999;82:697-703; doi:10.1136/hrt.82.6.697
Copyright © 1999 BMJ Publishing Group Ltd & British Cardiovascular Society
Heart 1999;82:697-703 ( December )

Left ventricular function in adults with mild pulmonary insufficiency late after Fallot repair

R A Niezena, W A Helbingd, E E van der Wallb, R J van der Geestc, H W Vliegenb, A de Roosa

a Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, 2333 AA Leiden, Netherlands, b Department of Cardiology, Leiden University Medical Centre, c Laboratory for Clinical and Experimental Image Processing, Leiden University Medical Centre, d Division of Paediatric Cardiology of the Department of Paediatrics, Leiden University Medical Centre

Correspondence to: Dr de Roos. email: a.de_roos{at}radiology.azl.nl

Accepted for publication 7 June 1999

OBJECTIVE---To assess left ventricular function in adult Fallot patients with residual pulmonary regurgitation.
SETTING---The radiology department of a tertiary referral centre.
PATIENTS---14 patients with chronic pulmonary regurgitation and right ventricular volume overload after repair of tetralogy of Fallot and 10 healthy subjects were studied using magnetic resonance imaging.
MAIN OUTCOME MEASURES---Biventricular volumes, global biventricular function, and regional left ventricular function were assessed in all subjects.
RESULTS---The amount of pulmonary regurgitation in patients (mean (SD)) was 25 (18)% of forward flow and correlated significantly with right ventricular enlargement (p < 0.05). Left ventricular end diastolic volume was decreased in patients (78 (11) v 88 (10) ml/m2; p < 0.05), ejection fraction was not significantly altered (59 (5)% v 55 (7)%; NS). No significant correlation was found between pulmonary regurgitation and left ventricular function. Overall left ventricular end diastolic wall thickness was significantly lower in patients (5.06 (0.72) v 6.06 (1.06) mm; p < 0.05), predominantly in the free wall. At the apical level, left ventricular systolic wall thickening was 20% higher in Fallot patients (p < 0.05). Left ventricular shape was normal.
CONCLUSIONS---Adult Fallot patients with mild chronic pulmonary regurgitation and subsequent right ventricular enlargement showed a normal left ventricular shape and global function. Although the left ventricular free wall had reduced wall thickness, compensatory hypercontractility of the apex may contribute to preserved global function.


Keywords: left ventricular function; pulmonary insufficiency; tetralogy of Fallot; magnetic resonance imaging

© 1999 by Heart
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