The Use of Automated Atrial CMR Measures and a Novel Atrioventricular Coupling Index for Predicting Risk in Repaired Tetralogy of Fallot

Authors

• Megan Gunsaulus
• Alejandra Bueno
• Carley Bright
• Katelyn Snyder
• Nikkan Das
• Craig Dobson
• Mark DeBrunner
• Adam Christopher
• Arvind Hoskoppal
• Christopher Follansbee
• Gaurav Arora
• Laura Olivieri
• Tarek Alsaied

Language

English

Publication Date

2-18-2023

Journal

Children

DOI

10.3390/children10020400

PMID

36832529

PMCID

PMC9955804

PubMedCentral® Posted Date

2-18-2023

PubMedCentral® Full Text Version

Post-print

Abstract

Atrial size and function have been recognized as markers of diastolic function, and diastolic dysfunction has been identified as a predictor of adverse outcomes in repaired tetralogy of Fallot (rTOF). This was a retrospective single-center study with the objective of investigating the use of atrial measurements obtained via CMR for predicting outcomes in rTOF patients. Automated contours of the left and right atria (LA and RA) were performed. A novel parameter, termed the Right Atrioventricular Coupling Index (RACI), was defined as the ratio of RA end-diastolic volume to right ventricle (RV) end-diastolic volume. Patients were risk-stratified using a previously validated Importance Factor Score for the prediction of life-threatening arrhythmias in rTOF. Patients with a high-risk Importance Factor Score (>2) had a significantly larger minimum RA volume (p = 0.04) and RACI (p = 0.03) compared to those with scores ≤2. ROC analysis demonstrated RACI to be the best overall predictor of a high-risk Importance Factor Score (AUC 0.73, p = 0.03). Older age at the time of repair and a diagnosis of pulmonary atresia were associated with a larger RACI. Automated atrial CMR measurements are easily obtained from standard CMRs and have the potential to serve as noninvasive predictors of adverse outcomes in rTOF.

Keywords

tetralogy of Fallot, cardiac MRI, diastolic function, atrial size, right atrioventricular coupling index (RACI)

Published Open-Access

yes

Recommended Citation

Gunsaulus, Megan; Bueno, Alejandra; Bright, Carley; et al., "The Use of Automated Atrial CMR Measures and a Novel Atrioventricular Coupling Index for Predicting Risk in Repaired Tetralogy of Fallot" (2023). Faculty, Staff and Student Publications. 4146.
https://digitalcommons.library.tmc.edu/uthmed_docs/4146