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Abstract #0307

Insight of right ventricular dysfunction and impaired efficiency via 4D flow CMR in repaired tetralogy of Fallot

Xiaodan Zhao1, Liwei Hu2, Ru-San Tan1,3, Ping Chai4, Marielle Fortier3,5, Rong Zhen Ouyang2, Shuo Zhang6, Wen Ruan1, Ting Ting Low4, Shuang Leng1, Jun-Mei Zhang1,3, Bryant Jennifer1, Lynette Teo4, Rob van der Geest7, Teng Hong Tan3,5, James W. Yip4, Ju Le Tan1,3, Yumin Zhong2, and Liang Zhong1,3
1National Heart Centre Singapore, Singapore, Singapore, 2Shanghai Children’s Medical Centre, Shanghai, China, 3Duke-NUS Medical School, Singapore, Singapore, 4National University Hospital Singapore, Singapore, Singapore, 5KK Women’s and Children’s Hospital, Singapore, Singapore, 6Philips Germany, Humburg, Germany, 7Leiden University Medical Center, Leiden, Netherlands

4D flow CMR enables qualitative and quantitative assessment of intra-cardiac flow. Kinetic energy (KE) and pathline-derived four flow components for left ventricular (LV) and right ventricular (RV) were analyzed and compared in repaired tetralogy of Fallot (rTOF) and age-matched controls. For RV, rTOF had increased peak systolic, systolic and peak E-wave KE normalized to end-diastolic volume while decreased efficiency index. RV direct flow decreased while RV residual volume increased from controls to rTOF with preserved RVEF (rTOFpEF) to rTOF with reduced RVEF. ROC analysis showed RV direct flow and efficiency index were sensitive markers to detect RV dysfunction in rTOFpEF.

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