Open Heart最新文献

{"title":"Ending nuclear weapons, before they end us.","authors":"Chris Zielinski","doi":"10.1136/openhrt-2025-003426","DOIUrl":"10.1136/openhrt-2025-003426","url":null,"abstract":"","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ratio of interventricular septal thickness to global longitudinal strain accurately identifies cardiac amyloidosis.","authors":"Louie Cao, Gloria J Hong, Michael Abiragi, Jonathan Le, P Ryan Tacon, I-Min Chiu, Jignesh Patel, Lily K Stern, Chathuri Daluwatte, David Ouyang, Piero Ricchiuto","doi":"10.1136/openhrt-2024-003120","DOIUrl":"10.1136/openhrt-2024-003120","url":null,"abstract":"<p><strong>Objectives: </strong>Conventional transthoracic echocardiographic measurements like global longitudinal strain (GLS) have shown promise in distinguishing cardiac amyloidosis (CA), but with limited specificity. We investigated the performance of common echo measurements, GLS, and their combinations in discriminating CA from an undifferentiated cohort with increased left ventricular wall thickness.</p><p><strong>Methods: </strong>We conducted a retrospective single-centre case-control study of 876 echos from 232 patients with CA and 1325 echos from 279 patients who underwent pyrophosphate scintigraphy but had CA definitively ruled out. Common echo measurements were collected and additional GLS measurements were performed post hoc. We reported discrimination performance with the area under the receiver operating characteristic curve (AUC) and associated sensitivity, specificity and positive predictive value at the optimal threshold.</p><p><strong>Results: </strong>We found that the ratio of end-diastolic interventricular septal thickness (IVSd) to GLS had the highest performance in differentiating CA with an AUC of 0.812. At the optimal threshold of >0.15, IVSd/GLS had a sensitivity of 0.70 and specificity of 0.80 for CA. Other measurements and ratios, including the ratio of left ventricular ejection fraction to GLS (AUC 0.682), had lower performance when evaluated against a suspicious control cohort with increased left ventricular wall thickness.</p><p><strong>Conclusion: </strong>If validated in prospective multi-centre studies, the routine measurement of IVSd/GLS can assist with earlier diagnosis of CA, resulting in earlier initiation of treatment in this underserved population.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value and clinical impact of cardiac magnetic resonance imaging in patients after sudden cardiac arrest: a retrospective study.","authors":"Elke Boxhammer, Richard Rezar, Stefan Hecht, Christoph Knapitsch, Nikolaos Schörghofer, Bernhard Strohmer, Reinhard Kaufmann, Uta C Hoppe, Klaus Hergan, Bernhard Scharinger","doi":"10.1136/openhrt-2024-003090","DOIUrl":"10.1136/openhrt-2024-003090","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac MRI (CMRI) is an important investigation in cases of unclear cause of sudden cardiac arrest (SCA). It demonstrates diagnostic utility in assessing reversibility and tissue scar burden and ultimately aids in further treatment planning.</p><p><strong>Methods: </strong>A retrospective analysis of all adult patients referred for CMRI after SCA between 2007 and 2022 by local intensive care units in our institution was performed. The patient cohort is highly selective, excluding those who did not reach the hospital, had cerebral oedema or had confirmed acute myocardial infarction as the cause of SCA. Data on clinical presentation, imaging findings and subsequent management were collected and analysed.</p><p><strong>Results: </strong>CMRI was diagnostic in 57 of 65 patients. The most common diagnosis by CMRI was ischaemic cardiomyopathy (28.1%), followed by dilated cardiomyopathy (17.5%) and structurally normal hearts (14%). In cases of myocardial oedema, extracellular volume (ECV) was determined in 10 patients and found to be elevated in 80% after resuscitation, whereas T2 mapping was elevated in only 50% of cases. The number of examinations has increased, whereas the time to examination has decreased over the years. Additionally, CMRI findings led to changes in treatment planning.</p><p><strong>Conclusion: </strong>CMRI after resuscitation is gaining increasing interest and clinical relevance as it provides additional diagnostic information that may be crucial for therapy planning. The sensitivity of ECV in detecting myocardial oedema after cardiac arrest highlights its potential utility over T2 mapping. Future studies should investigate the impact of CMRI on long-term patient outcomes and further refine its role in guiding treatment decisions.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular disease burden in the homeless population.","authors":"Samhita Korukonda, Nikith Erukulla, Jeffrey R Harris, Pranitha Kovuri, Kenneth Tyler Wilcox","doi":"10.1136/openhrt-2025-003190","DOIUrl":"10.1136/openhrt-2025-003190","url":null,"abstract":"<p><strong>Introduction: </strong>The burden of cardiovascular disease (CVD) among the homeless population has been rising, driven by factors such as lack of healthcare access, rising mental health disorders and substance use. This study aims to systematically analyse the CVD burden among homeless adults and characterise its prevalence and risk factors. Additionally, our literature review revealed a significant lack of cardiac-focused interventions in this population, thus we build on existing models to propose new CVD-specific interventions.</p><p><strong>Methods: </strong>A comprehensive systematic review and meta-analysis were performed on data collected from PubMed and Scopus until 22 October 2024. All observational studies that assessed homeless populations and met inclusion criteria were analysed. The primary outcomes reported were mortality, morbidity and hospitalisation due to CVD. These measures were collectively analysed to evaluate the overall CVD burden.</p><p><strong>Results: </strong>Our search strategy identified 22 studies, of which 12 were suitable for meta-analysis. We analysed data from 226 205 adults spanning more than 1 000 000 person-years and sought to characterise CVD distribution by demographic subgroups. Our findings indicate that homeless adults experience greater morbidity and mortality due to CVD than non-homeless adults (pooled OR 2.77; 95% CI 1.93 to 3.93; p<0.001; I² <i>=</i>96.2%). Subgroup analyses by age, sex and geographic region were performed, but no significant differences in CVD morbidity and mortality were found.</p><p><strong>Conclusion: </strong>Homeless adults have approximately three times greater odds of CVD than the general population. We found that the risk of CVD remains elevated regardless of demographic subgroup. Our findings emphasise the urgent need for targeted interventions within this population and highlight its associated risk factors, providing a foundation for the development of targeted interventions and policies.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features of non-compaction cardiomyopathy across age groups: a retrospective study of 415 patients.","authors":"Ziqin Zhou, Min Qiu, Ruyue Zhang, Ying Li, Miao Tian, Jiazichao Tu, Linjiang Han, Shuheng Zhou, Xinming Li, Jian Zhuang, Shusheng Wen, Jimei Chen","doi":"10.1136/openhrt-2024-003030","DOIUrl":"https://doi.org/10.1136/openhrt-2024-003030","url":null,"abstract":"<p><strong>Background: </strong>Non-compaction cardiomyopathy (NCM) is a rare inherited cardiac disorder associated with adverse cardiovascular outcomes, including heart failure, arrhythmias and sudden cardiac death. Currently, the clinical manifestations of NCM lack comprehensive characterisation across different age groups in large-scale studies. This investigation aims to systematically analyse the clinical characteristics of patients with NCM across various age demographics.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 415 patients with NCM treated at the Guangdong Institute of Cardiovascular Disease from January 2013 to January 2023. We comprehensively collected and analysed clinical data, including presenting symptoms, arrhythmia patterns, echocardiographic parameters and cardiac magnetic resonance imaging findings.</p><p><strong>Results: </strong>The study cohort (n=415) was stratified into three age groups: infants (0-1 year, n=169), children/adolescents (1-18 years, n=149) and adults (>18 years, n=97). Heart failure was the predominant clinical manifestation across the entire cohort, affecting 112 patients (27%). Notably, heart failure was most prevalent in adult patients (54.6%, n=53), while cardiac murmur was the primary presenting symptom in both infant and child/adolescent groups (19.5%, n=33 and 17.4%, n=26, respectively). Across all age groups, patients with NCM with concurrent mitral regurgitation (MR) demonstrated significantly reduced left ventricular ejection fraction and fractional shortening compared with those without valvular disease (p<0.05). Additionally, left ventricular end-systolic diameter (LVESD) and end-diastolic diameter (LVEDD) were significantly increased in patients with MR (p<0.05). A significant correlation was observed between both LVESD and LVEDD measurements and MR area in patients with NCM (p<0.05).</p><p><strong>Conclusion: </strong>Patients with NCM with concomitant MR consistently exhibited left ventricular dilatation and systolic dysfunction across all age groups. Significant age-related variations were observed in clinical presentations, arrhythmia patterns and the prevalence of congenital and valvular heart disease. Understanding these age-specific clinical characteristics is crucial for accurate diagnosis, optimal therapeutic management and future research directions in NCM.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High afterload rather than myocardial fibrosis predicts reduced ejection fraction in severe aortic stenosis with afterload mismatch.","authors":"Megan Rian Rajah, Anton Doubell, Philip Herbst","doi":"10.1136/openhrt-2025-003345","DOIUrl":"https://doi.org/10.1136/openhrt-2025-003345","url":null,"abstract":"<p><strong>Background: </strong>Afterload mismatch (AM) refers to high-gradient (mean gradient ≥40 mm Hg) severe aortic stenosis (AS) with reduced left ventricular ejection fraction (LVEF <50%) that is hypothesised to arise from mechanisms other than true contractile impairment. The extent, pattern and functional impact of myocardial fibrosis (MF), which is associated with systolic impairment, is poorly understood in the context of AM.</p><p><strong>Methods: </strong>High-gradient severe AS patients with (n=25; low ejection fraction high-gradient, LEF-HG) and without (n=33; normal ejection fraction high-gradient (NEF-HG)) reduced LVEF underwent cardiovascular MRI. Using T1 mapping, extracellular volume (ECV) fraction and late gadolinium enhancement (LGE), the extent and pattern of MF was compared between the two groups. End-systolic wall stress (ESWS) as a measure of afterload was estimated, and its relationship with LVEF was compared with that of MF and LVEF.</p><p><strong>Results: </strong>Stenosis severity was worse in the LEF-HG group (aortic valve area 0.5±0.2 vs 0.7±0.2 cm², mean gradient 55 (46-66) vs 48 (41-69) mm Hg). In the LEF-HG group, high ESWS with cavity dilation and significant hypertrophy were observed compared with the NEF-HG group. MF was present in both groups with a significantly higher burden in the LEF-HG group (T1 time 1061±22 vs 1041±33 ms, ECV 26%±3% vs 24%±3%, LGE mass 4.3 (1.7-9.3) vs 0.1 (0.06-3.39) g). The association between MF and LVEF was weak, while ESWS was strongly associated with LVEF (r -0.8, p<0.0001) and was the best predictor of LVEF in multivariate prediction analysis.</p><p><strong>Conclusions: </strong>MF was present in both groups with a higher burden in those with LEF-HG AS. High ESWS, that is, afterload, rather than MF, was the strongest predictor of LVEF. While MF may not directly impact systolic function in AM, it is still an important factor to account for in AS given its association with increased mortality.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four-dimensional flow provides incremental diagnostic value over echocardiography in aortic stenosis.","authors":"Ciaran Grafton-Clarke, Hosamadin Assadi, Rui Li, Zia Mehmood, Rimma Hall, Gareth Matthews, Vasiliki Tsampasian, Samer Alabed, Bahman Kasmai, Laura Staff, John Curtin, Gurung-Koney Yashoda, Julia Sun, Sunil Nair, David Hewson, Kurian Thampi, Jordi Broncano, Fabrizio Ricci, Peter Swoboda, Andrew J Swift, Vassilios S Vassiliou, Rob J van der Geest, Pankaj Garg","doi":"10.1136/openhrt-2024-003081","DOIUrl":"10.1136/openhrt-2024-003081","url":null,"abstract":"<p><strong>Aims: </strong>Four-dimensional flow cardiovascular MRI (4D flow CMR) has emerged as a promising technique for assessing aortic stenosis (AS). This study aimed to evaluate the agreement between 4D flow CMR and transthoracic echocardiography (TTE) in estimating peak aortic valve (AV) velocities (V_Peak), grading AS severity and predicting AV intervention in a real-world setting.</p><p><strong>Methods: </strong>Participants from the PREFER-CMR registry who had consecutive TTE and 4D flow CMR were included. AS severity was graded using established protocols using three echocardiographic parameters (V_Peak, AV area and mean pressure gradient) and CMR-derived V_Peak.</p><p><strong>Results: </strong>The study recruited 30 patients (mean age 75.4 years, 67% male), with 17 undergoing AV intervention. Continuous wave Doppler (CWD) V_Peak (3.4 vs 2.6 m/s, p=0.0025) and 4D flow V_Peak (4.2 vs 2.7 m/s, p<0.0001) were significantly higher in patients going for AV intervention. V_Peak by CWD was significantly lower to 4D flow with a bias of -0.5 (p=0.01) and a correlation of (R=0.55, p=0.002). The Cox-regression analysis reveals that 4D flow V_Peak significantly predicts AV intervention (HR=2.51, p<0.01), while CWD V_Peak (HR=0.54, p=0.76) shows no significant association; overall model fit is significant (χ²=9.5, p=0.02).</p><p><strong>Conclusion: </strong>4D flow CMR-derived V_Peak assessment is superior to echocardiographic CWD assessment for predicting timing of AV intervention.</p><p><strong>Trial registration number: </strong>NCT05114785.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections on the James Lind Alliance priority setting partnership in congenital heart disease.","authors":"Nigel E Drury, Katherine L Brown, Louise Coats, Giovanni Biglino, Sarah Murray","doi":"10.1136/openhrt-2025-003342","DOIUrl":"https://doi.org/10.1136/openhrt-2025-003342","url":null,"abstract":"","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incident HFpEF and time-dependent changes in markers of LVDD severity in women and men with preclinical LVDD.","authors":"Anne Margje Lisa Naomi van Ommen, Elisa Dal Canto, Ernest Diez Benavente, Maarten Jan Cramer, Arco J Teske, Roxana Menken, Karim Taha, M Louis Handoko, Dirk J Duncker, Marianne C Verhaar, Frans H Rutten, N Charlotte Onland-Moret, Hester M den Ruijter","doi":"10.1136/openhrt-2024-003105","DOIUrl":"10.1136/openhrt-2024-003105","url":null,"abstract":"<p><strong>Background: </strong>The progression of left ventricular diastolic dysfunction (LVDD) over time may lead to the development of heart failure with preserved ejection fraction (HFpEF). HFpEF is twice as common in women compared with men; however, the sex-specific progression from LVDD towards HFpEF is poorly described. Therefore, we aim to evaluate changes over time in markers of LVDD severity and HFpEF in women and men with preclinical LVDD.</p><p><strong>Methods and results: </strong>We reassessed 146 participants from the HELPFul study (58% women and 42% men) with preclinical LVDD after a median follow-up of 4.3 (IQR: 3.9-4.7) years. The follow-up measurements mirrored baseline measurements, encompassing clinical examination, blood draw for biomarkers and echocardiography. We determined HFpEF incidence and report changes over time in echocardiography. Additionally, we studied how blood pressure and kidney function affected LVDD progression, including plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, using generalised mixed models. All analyses were performed for women and men combined, and sex stratified. Out of 146 participants, 15 (10%) developed HF of whom 13 had HFpEF (9 women and 4 men). Over time, mean kidney function (estimated glomerular filtration rate, eGFR) declined from 89±14.4 to 81±16.9 mL/min/1.73 m² and median NT-proBNP plasma levels increased from 71 (IQR: 44-120) to 100 (IQR: 51-157) pg/mL. In women, a higher systolic and in men a higher diastolic blood pressure were associated with an increase in NT-proBNP plasma levels over time. Lower eGFR levels were related to increased NT-proBNP plasma levels over time in both men and women.</p><p><strong>Conclusions: </strong>Our study demonstrates that only a small proportion of women and men with preclinical LVDD develop incident HF over a roughly 5-year follow-up period. High blood pressure and decreased kidney function were associated with higher levels of NT-proBNP. This highlights the need to further explore cardiorenal protection as a method to prevent HFpEF.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simple ECG-based score and clinical parameters to predict right ventricular dilation in patients with repaired tetralogy of fallot.","authors":"Pornphairin Satawichairut, Paweena Chungsomprasong, Watcharachai Kangvanskol, Chodchanok Vijarnsorn, Karnkawin Patharateeranart, Prakul Chanthong, Supaluck Kanjanauthai, Thita Pacharapakornpong, Ploy Thammasate, Kritvikrom Durongpisitkul, Jarupim Soongswang","doi":"10.1136/openhrt-2025-003255","DOIUrl":"https://doi.org/10.1136/openhrt-2025-003255","url":null,"abstract":"<p><strong>Background: </strong>Cardiac magnetic resonance (CMR) is the gold standard for assessing right ventricular (RV) function in repaired tetralogy of Fallot (rTOF), but it is expensive and not always available. ECG is a cost-effective, accessible alternative. This study evaluated ECG parameters, specifically QRS duration (QRSd) and QRS fragmentation (QRSf), to predict RV volumes and function, and developed a new score to guide CMR timing.</p><p><strong>Methods: </strong>We retrospectively analysed 147 patients with rTOF with pulmonary regurgitation. ECG, echocardiographic and CMR data were collected. Receiver operating characteristic curves identified optimal cut-offs for predicting RV dysfunction and dilation. Logistic regression was used to determine predictors of RV dysfunction and dilation.</p><p><strong>Results: </strong>QRSd showed moderate positive correlations with RV end-diastolic (EDVi) and end-systolic (ESVi) volume indices and negative correlations with RV ejection fraction (EF) and global radial strain. QRSf was associated with larger RVESVi and lower RVEF. We propose a simple risk score of age ≤20 years, QRSd≥160 ms, QRSf and transannular patch repair. A score >2.5 out of 5.5 predicted RVEDVi ≥150 mL/m² with 76.5% sensitivity and 63.6% specificity.</p><p><strong>Conclusions: </strong>This study highlights the value of ECG, particularly QRSd≥160 ms and QRSf, in predicting RV dilation in rTOF. The proposed score, based on clinical data and ECG parameters, offers a practical tool for guiding the timing of CMR.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}