Pekka Ylitalo , Olli M. Pitkänen , Kirsi Lauerma , Miia Holmström , Otto Rahkonen , Markku Heikinheimo , Heikki Sairanen , Eero Jokinen
{"title":"儿童法洛四联症修复后的晚期钆增强(LGE)进展与右心室容积有关","authors":"Pekka Ylitalo , Olli M. Pitkänen , Kirsi Lauerma , Miia Holmström , Otto Rahkonen , Markku Heikinheimo , Heikki Sairanen , Eero Jokinen","doi":"10.1016/j.ijchv.2014.01.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Fibrosis after myocardial damage can be determined by cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE). We studied whether ventricular LGE is visible in the ventricles of pediatric and adolescent TOF (tetralogy of Fallot) patients by measuring LGE and investigating whether fibrosis correlated with right ventricular volume, pulmonary regurgitation, N-terminal pro-brain natriuretic peptide (NT-proBNP) or the aminoterminal propeptide of type III procollagen (PIIINP). We also studied if the patient's age, post-operative follow-up time or surgical history would affect LGE.</p></div><div><h3>Methods</h3><p>A total of 40 pediatric patients who had undergone TOF repair and 43 healthy age and gender matched controls underwent a CMR study, whereby LGE was scored in the right (RV) and the left ventricle. To exclude the possible iatrogenic scarring we calculated the LGE score by excluding the right ventricular outflow tract and VSD patch region.</p></div><div><h3>Results</h3><p>All patients had RV LGE and in 39 of 40 it was seen also outside the surgically affected areas. The amount of LGE correlated positively with the RV end-diastolic volume (r = 0.44, P = 0.0045), pulmonary regurgitation (r = 0.40, P = 0.013), and with NT-proBNP. The presence of LGE also depended on post-operative follow-up time (r = 0.53, P = 0.006). PIIINP levels of TOF patients were significantly higher than in the control subjects but it did not correlate with LGE or with any of the studied clinical markers.</p></div><div><h3>Conclusions</h3><p>LGE is present globally in the right ventricular muscle in children and adolescents with TOF. The longer the follow-up time the more common was the LGE in the right ventricle.</p></div>","PeriodicalId":90542,"journal":{"name":"International journal of cardiology. Heart & vessels","volume":"3 ","pages":"Pages 15-20"},"PeriodicalIF":0.0000,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchv.2014.01.002","citationCount":"10","resultStr":"{\"title\":\"Late gadolinium enhancement (LGE) progresses with right ventricle volume in children after repair of tetralogy of fallot\",\"authors\":\"Pekka Ylitalo , Olli M. Pitkänen , Kirsi Lauerma , Miia Holmström , Otto Rahkonen , Markku Heikinheimo , Heikki Sairanen , Eero Jokinen\",\"doi\":\"10.1016/j.ijchv.2014.01.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Fibrosis after myocardial damage can be determined by cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE). We studied whether ventricular LGE is visible in the ventricles of pediatric and adolescent TOF (tetralogy of Fallot) patients by measuring LGE and investigating whether fibrosis correlated with right ventricular volume, pulmonary regurgitation, N-terminal pro-brain natriuretic peptide (NT-proBNP) or the aminoterminal propeptide of type III procollagen (PIIINP). We also studied if the patient's age, post-operative follow-up time or surgical history would affect LGE.</p></div><div><h3>Methods</h3><p>A total of 40 pediatric patients who had undergone TOF repair and 43 healthy age and gender matched controls underwent a CMR study, whereby LGE was scored in the right (RV) and the left ventricle. To exclude the possible iatrogenic scarring we calculated the LGE score by excluding the right ventricular outflow tract and VSD patch region.</p></div><div><h3>Results</h3><p>All patients had RV LGE and in 39 of 40 it was seen also outside the surgically affected areas. The amount of LGE correlated positively with the RV end-diastolic volume (r = 0.44, P = 0.0045), pulmonary regurgitation (r = 0.40, P = 0.013), and with NT-proBNP. The presence of LGE also depended on post-operative follow-up time (r = 0.53, P = 0.006). PIIINP levels of TOF patients were significantly higher than in the control subjects but it did not correlate with LGE or with any of the studied clinical markers.</p></div><div><h3>Conclusions</h3><p>LGE is present globally in the right ventricular muscle in children and adolescents with TOF. The longer the follow-up time the more common was the LGE in the right ventricle.</p></div>\",\"PeriodicalId\":90542,\"journal\":{\"name\":\"International journal of cardiology. Heart & vessels\",\"volume\":\"3 \",\"pages\":\"Pages 15-20\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2014-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.ijchv.2014.01.002\",\"citationCount\":\"10\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of cardiology. Heart & vessels\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2214763214000042\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of cardiology. Heart & vessels","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214763214000042","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 10
摘要
背景心肌损伤后的纤维化可以通过心脏磁共振(CMR)和晚期钆增强(LGE)来确定。我们通过测量LGE并研究纤维化是否与右心室容积、肺反流、n端前脑利钠肽(NT-proBNP)或III型前胶原的氨基端前肽(PIIINP)相关,研究了儿童和青少年TOF(法洛四联症)患者心室是否可见心室LGE。我们还研究了患者的年龄、术后随访时间和手术史是否会影响LGE。方法对40例接受TOF修复的儿童患者和43例年龄和性别匹配的健康对照组进行CMR研究,分别在右心室和左心室进行LGE评分。为了排除可能的医源性瘢痕,我们通过排除右心室流出道和室间隔贴片区域来计算LGE评分。结果所有患者均有RV LGE,其中39例在手术影响区外也可见。LGE的量与右心室舒张末期容积(r = 0.44, P = 0.0045)、肺反流(r = 0.40, P = 0.013)、NT-proBNP呈正相关。LGE的存在也与术后随访时间有关(r = 0.53, P = 0.006)。TOF患者的PIIINP水平明显高于对照组,但与LGE或任何研究的临床标志物无关。结论儿童和青少年TOF患者右心室肌普遍存在slge。随访时间越长,右心室LGE越常见。
Late gadolinium enhancement (LGE) progresses with right ventricle volume in children after repair of tetralogy of fallot
Background
Fibrosis after myocardial damage can be determined by cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE). We studied whether ventricular LGE is visible in the ventricles of pediatric and adolescent TOF (tetralogy of Fallot) patients by measuring LGE and investigating whether fibrosis correlated with right ventricular volume, pulmonary regurgitation, N-terminal pro-brain natriuretic peptide (NT-proBNP) or the aminoterminal propeptide of type III procollagen (PIIINP). We also studied if the patient's age, post-operative follow-up time or surgical history would affect LGE.
Methods
A total of 40 pediatric patients who had undergone TOF repair and 43 healthy age and gender matched controls underwent a CMR study, whereby LGE was scored in the right (RV) and the left ventricle. To exclude the possible iatrogenic scarring we calculated the LGE score by excluding the right ventricular outflow tract and VSD patch region.
Results
All patients had RV LGE and in 39 of 40 it was seen also outside the surgically affected areas. The amount of LGE correlated positively with the RV end-diastolic volume (r = 0.44, P = 0.0045), pulmonary regurgitation (r = 0.40, P = 0.013), and with NT-proBNP. The presence of LGE also depended on post-operative follow-up time (r = 0.53, P = 0.006). PIIINP levels of TOF patients were significantly higher than in the control subjects but it did not correlate with LGE or with any of the studied clinical markers.
Conclusions
LGE is present globally in the right ventricular muscle in children and adolescents with TOF. The longer the follow-up time the more common was the LGE in the right ventricle.