Differential Adaptation of Biventricular Myocardial Kinetic Energy in Patients With Repaired Tetralogy of Fallot Assessed by MR Tissue Phase Mapping

Shi-Ying Ke; Ken-Pen Weng; Meng-Chu Chang; Ming-Ting Wu; Yi-He Li; Kuang-Jen Chien; Chu-Chuan Lin; Kai-Sheng Hsieh; Ming-Hua Chang; Jun-Yen Pan; Hsu-Hsia Peng

doi:10.1002/jmri.28420

Differential Adaptation of Biventricular Myocardial Kinetic Energy in Patients With Repaired Tetralogy of Fallot Assessed by MR Tissue Phase Mapping

J Magn Reson Imaging. 2023 May;57(5):1492-1504. doi: 10.1002/jmri.28420. Epub 2022 Sep 12.

Authors

Shi-Ying Ke¹, Ken-Pen Weng^{2

3}, Meng-Chu Chang¹, Ming-Ting Wu^{2

4

5}, Yi-He Li⁴, Kuang-Jen Chien³, Chu-Chuan Lin³, Kai-Sheng Hsieh⁶, Ming-Hua Chang⁴, Jun-Yen Pan^{3

7}, Hsu-Hsia Peng¹

Affiliations

¹ Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan.
² School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
³ Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
⁴ Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
⁵ Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁶ Department of Pediatrics, China Medical University Children's Hospital, Taichung, Taiwan.
⁷ Department of Cardiovascular Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

PMID: 36094105
DOI: 10.1002/jmri.28420

Abstract

Background: The myocardial kinetic energy (KE) and its association with pulmonary regurgitation (PR) have yet to be investigated in repaired tetralogy of Fallot (rTOF) patients.

Purpose: To evaluate the adaptation of myocardial KE in rTOF patients by tissue phase mapping (TPM).

Study type: Prospective.

Population: A total of 49 rTOF patients (23 ± 5 years old; male = 32), 47 normal controls (22 ± 1 year old; male = 29).

Field strength/sequence: 3-T/2D dark-blood three-directional velocity-encoded gradient-echo sequence.

Assessment: Left and right ventricle (LV, RV) myocardial KE in radial (KE_r ), circumferential (KE_ø ), longitudinal (KE_z ) directions. The proportions of KE in each direction to the sum of all KE (KE_røz ): %KE_r , %KE_ø , %KE_z . PR fraction.

Statistical test: Student's t test, multivariable regression. Statistical significance: P < 0.05.

Results: In rTOF group, LV KE_z remained normal in systole (P = 0.565) and diastole (P = 0.210), whereas diastolic LV %KE_z (62% ± 14% vs. 72% ± 7%) and systolic LV %KE_ø (9% ± 6% vs. 20% ± 7%) were significantly decreased. The KE_r and %KE_r of both ventricles significantly increased in the rTOF group (RV in diastole: 6 ± 3 vs. 3 ± 1 μJ and 54% ± 13% vs. 27% ± 7%). The rTOF group exhibited significantly higher RV/LV ratios of %KE_r (systole: 1.3 ± 0.3 vs. 1.0 ± 0.3) and %KE_ø (systole: 1.6 ± 0.8 vs. 1.0 ± 0.3) and significantly lower ratios of %KE_z in systole (0.7 ± 0.2 vs. 1.0 ± 0.1) and diastole (0.5 ± 0.2 vs. 0.9 ± 0.1). In multivariable regression analysis, the RV peak systolic KE_røz , RV systolic KE_z , and LV diastolic %KE_ø were independently associated with PR fraction in the rTOF group (adjusted R² = 0.479).

Data conclusion: In rTOF patients, the adaptation of the KE proportion occurred earlier than that of the KE amplitude, and the biventricular balance of %KE was disrupted. PR may cause differential KE adaptation in RV and LV. TPM-derived KE may be useful in investigation of myocardial adaptation in rTOF patients.

Evidence level: 2 TECHNICAL EFFICACY: Stage 3.

Keywords: kinetic energy; myocardium; pulmonary regurgitation; tetralogy of Fallot.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Heart Ventricles
Humans
Male
Myocardium
Prospective Studies
Pulmonary Valve Insufficiency*
Tetralogy of Fallot* / surgery
Ventricular Function, Right
Young Adult