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 Tan^1,3, Ping Chai⁴, Marielle Fortier^3,5, Rong Zhen Ouyang², Shuo Zhang⁶, Wen Ruan¹, Ting Ting Low⁴, Shuang Leng¹, Jun-Mei Zhang^1,3, Bryant Jennifer¹, Lynette Teo⁴, Rob van der Geest⁷, Teng Hong Tan^3,5, James W. Yip⁴, Ju Le Tan^1,3, Yumin Zhong², and Liang Zhong^1,3

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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