Multimodality imaging, single center, cross-sectional study in adolescents or young adults with repaired tetralogy of Fallout

Background Proper integration of multiple imaging modalities in the routine follow-up of patients with repaired tetralogy of Fallout (TOF) is poorly supported by data. We report our single center comparative study between cardiac magnetic resonance (CMR) and echocardiography to assess equipoise in the clinical utility of these two imaging methods in an unselected consecutive cohort of TOF patients referred to our outpatient clinic. Material and methods In this cross-sectional study, repaired TOF patients who underwent CMR and echocardiography within a 4-week period between 2010 and 2011 at our Center were included. Linear regression was used to analyze degree of inter modality correlation. A prediction model tested the association between functional data/probrain natriuretic peptide (Pro-BNP) with CMR. Results Fifty patients were included in the study (mean age 31±18 years). The best predictors of right ventricle (RV) ejection fraction at CMR were tricuspid anular plane systolic excursion (tricuspid valve anular plane systolic excursion, R2 0.37, P<0.0001) and RV peak S-wave velocity (R2 0.40, P<0.001). Pro-BNP levels did present weak correlation with New York Heart Association functional class (R2 0.31, P<0.002) and QRS duration (R2 0.32, P<0.002) and a moderate correlation with right atrium area at CMR (R2 0.46, P<0.0001). Conclusion We found limited correlation between the two imaging modalities in the evaluation of RV after intracardiac repair of TOF. Pro-BNP level presents moderate correlation with right atrium area measured with echocardiography. Serial CMR evaluations are needed in this patient population, but they may be interchanged by routine echocardiography in particular in patients with normal or stable echocardiographic parameters.