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Master Thesis

Corrélations de la fibrose myocardique focale et diffuse chez les patients suivis pour tétralogie de Fallot corrigée : une étude IRM

Abstract : Background: left and right ventricular (LV and RV) remodeling in repaired tetralogy of Fallot (TOF) is poorly understood. Objectives: to identify correlates of focal scar and diffuse fibrosis in patients with history of TOF repair by using cardiac magnetic resonance (CMR). Methods : patients with prior TOF repair underwent CMR including cine imaging to assess ventricular volumes and ejection fraction (EF), T1 mapping to assess LV and RV diffuse fibrosis, and high resolution late gadolinium-enhanced (LGE) imaging to quantify scar size. Structural imaging data were related to clinical characteristics and functional imaging markers. In 40 patients, cine and T1 mapping results were compared to 40 age- and sex-matched controls. Results: sixty-four patients with TOF repair were enrolled (age 25±14 years, 19 women), including 18 with prior pulmonary valve (PV) replacement. Compared to controls, TOF patients showed lower LV and RVEF and higher RV volume, RV wall thickness, and native T1 and ECV values on both ventricles. Scar size related to LVEF and RVEF while LV and RV native T1 related to RV dilatation. Patients with history of ventricular arrhythmia showed larger scars and longer native T1. Patients with history of PV replacement showed larger scar on RV outflow tract but LV and RV native T1 were shorter. Conclusions: focal scar and biventricular diffuse fibrosis are detected on CMR after TOF repair. Scar size relates to systolic dysfunction, and diffuse fibrosis to RV dilatation. Both may be implicated in ventricular arrhythmias. The finding of shorter T1 after PV replacement suggests that diffuse fibrosis may reverse with therapy.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01766672
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, April 13, 2018 - 6:55:10 PM
Last modification on : Friday, April 20, 2018 - 1:22:47 AM

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Antoine Allain-Nicolaï. Corrélations de la fibrose myocardique focale et diffuse chez les patients suivis pour tétralogie de Fallot corrigée : une étude IRM. Médecine humaine et pathologie. 2018. ⟨dumas-01766672⟩

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