Magnetic resonance imaging of the heart as a method of long-term monitoring of right heart function after tetralogy of Fallot surgery

Milinković, Biljana; Marić, Jelena; Bokonjić, Dejan; Prodanović, Verica; Joksimović, Bojan; Ristić, Siniša

doi:10.5937/BII2201001M

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Biomedicinska istraživanja

2022, vol. 13, br. 1, str. 1-10

Magnetna rezonanca srca kao metod dugoročnog praćenja funkcije desnog srca nakon operacije tetralogije Fallot

Milinković Biljana^a, Marić Jelena^a, Bokonjić Dejan^b, Prodanović Verica^a, Joksimović Bojan^b, Ristić Siniša^b

^aUniversity Hospital Foča, The Republic of Srpska, Bosnia and Herzegovina
^bUniverzitet u Istočnom Sarajevu, Medicinski fakultet, Foča, Republika Srpska, BiH

e-adresa: milinkovic.biljana@yahoo.com

Ključne reči: tetralogija Fallot; disfunkcija desne komore; magnetna rezonanca srca

Sažetak

Uvod. Magnetna rezonanca srca (engl. Cardiac magnetic resonance - CMR) se smatra referentnom dijagnostičkom metodom za kvantifikaciju veličine i funkcije desne komore i pulmonalne regurgitacije kod pacijenata sa operisanom tetralogijom Fallot. Cilj ovog rada je da potvrdi važnost magnetno-rezonantnog kontinuiranog postoperativnog praćenja parametara funkcije desnog i lijevog srca kao dijagnostičke metode koja pruža najprecizniju i najtačniju procjenu. Metode. Opservaciono-prospektivna studija uključila je ispitanike sa operisanom TOF kojima su na kontrolnim postoperativnim ehokardiografskim pregledima utvrđeni rezidualni morfološki i/ili funkcionalni poremećaji. Svim ispitanicima je urađena magnetna rezonanca srca na skeneru jačine 1.5 T sa namjenskim zavojnicama za srčanu površinu prema standardnom protokolu u periodu od godinu dana od početka istraživanja. Kriterijumi za isključenje iz studije bili su: značajna rezidualna pulmonalna stenoza, stanje poslije zamjene pulmonalne valvule, postojanje rezidualnih šant lezija; kontraindikacije za magnetnu rezonancu srca (pace-maker, ICD, klaustrofobija). U zavisnosti od vremena proteklog od operacije tetralogije Fallot, ispitanici su podijeljeni u grupe: više od 15 godina, 11-15 godina, 6-10 godina, manje od 5 godina. Rezultati. Studijom je obuhvaćen 131 ispitanik prosječne starosti 24,18 ± 11,57 godina sa urađenom kompletnom korekcijom TOF. Dokazane međugrupne razlike u vrijednostima end-dijastolnog volumena desne komore, ejekcione frakcije desne komore, kao i ejekcione frakcije lijeve komore, ali nije bilo statistički značajne međugrupne razlike u vrijednosti frakcije pulmonalne regurgitacije. Negativna interreakcija desne i lijeve komore pojačava se u toku godina praćenja pacijenata nakon operacije TOF, što se posebno događa 15 godina nakon operacije. Zaključak. CMR ima najznačajniju ulogu u istraživačkim naporima usmjerenim na poboljšanje ishoda operisanih pacijenata sa tetralogijom Fallot.

Abstract

Introduction. Cardiac magnetic resonance imaging (CMR) is considered the reference diagnostic method for quantifying right ventricular size and function, and pulmonary regurgitation in patients with tetralogy of Fallot surgery. The aim of this paper is to confirm the importance of magnetic resonance continuous postoperative monitoring of right and left heart function parameters as a diagnostic method that provides the most precise and accurate assessment. Methods. The prospective observational study included subjects with TOF surgery who were diagnosed with residual morphological and/or functional disorders on control postoperative echocardiographic examinations. All subjects underwent magnetic resonance imaging of the heart on a 1.5 T scanner with dedicated coils for the heart surface according to the standard protocol for a period of one year from the beginning of the study. Criteria for exclusion from the study were: significant residual pulmonary stenosis, condition after pulmonary valve replacement, existence of residual shunt lesions, contraindications for cardiac magnetic resonance imaging (pacemaker, ICD, claustrophobia). Depending on the time elapsed since the tetralogy of Fallot surgery, the subjects were divided into groups: more than 15 years, 11-15 years, 6-10 years, less than 5 years. Results. The study included 131 subjects with an average age of 24.18 ± 11.57 years with complete correction of TOF. Intergroup differences in values of right ventricular end-diastolic volume, right ventricular ejection fraction, and left ventricular ejection fraction were demonstrated, but there was no statistically significant intergroup difference in values of pulmonary regurgitation fraction. The negative interaction of the right and left ventricles intensifies during the years of follow-up of patients after TOF surgery, which is especially true fifteen years after surgery. Conclusion. CMR has the most significant role in research efforts aimed at improving the outcomes of operated patients with tetralogy of Fallot.

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O članku

jezik rada: engleski
vrsta rada: originalan članak
DOI: 10.5937/BII2201001M
primljen: 25.10.2021.
prihvaćen: 12.04.2022.
objavljen u SCIndeksu: 16.09.2022.

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