The Interplay between Myocardial Fibrosis, Strain Imaging and Collagen Biomarkers in Adults with Repaired Tetralogy of Fallot

Background: We sought to assess the interplay between right ventricle (RV) fibrosis, biventricular dysfunction based on global longitudinal strain (GLS) analysis, and biomarkers such as Galectin-3 (Gal-3), procollagen type III (PCIII), and NTproBNP. Methods: We studied 35 adult patients with rToF. A...

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Autores principales:	Konstantina Karali, Kali Makedou, Alexandros Kallifatidis, Matthaios Didagelos, George Giannakoulas, Constantinos H. Davos, Theodoros D. Karamitsos, Antonios Ziakas, Haralambos Karvounis, Stavros Hadjimiltiades
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	myocardial fibrosis cardiac magnetic resonance feature tracking (CMR-FT) Galectin-3 Procolagen III NTproBNP adults with repaired tetralogy fallot Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/7e81e279b62e47858f80691a0b7aa874
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spelling	oai:doaj.org-article:7e81e279b62e47858f80691a0b7aa8742021-11-25T17:21:38ZThe Interplay between Myocardial Fibrosis, Strain Imaging and Collagen Biomarkers in Adults with Repaired Tetralogy of Fallot10.3390/diagnostics111121012075-4418https://doaj.org/article/7e81e279b62e47858f80691a0b7aa8742021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2101https://doaj.org/toc/2075-4418Background: We sought to assess the interplay between right ventricle (RV) fibrosis, biventricular dysfunction based on global longitudinal strain (GLS) analysis, and biomarkers such as Galectin-3 (Gal-3), procollagen type III (PCIII), and NTproBNP. Methods: We studied 35 adult patients with rToF. All patients underwent a cardiac magnetic resonance (CMR) scan including feature tracking for deformation imaging. Blood biomarkers were measured. Results: LGE RV was detected in all patients, mainly at surgical sites. Patients with the highest RV LGE scoring had greater RV dilatation and dysfunction whereas left ventricular (LV) function was preserved. LV GLS correlated with RV total fibrosis score (<i>p</i> = 0.007). A LV GLS value of −15.9% predicted LGE RV score > 8 (AUC 0.754 (<i>p</i> = 0.02)). Neither RV GLS nor biomarker levels were correlated with the extent of RV fibrosis. A cut-off value for NTproBNP of 145.25 pg/mL predicted LGE RV score > 8 points (AUC 0.729, (<i>p</i> = 0.03)). A cut-off value for Gal-3 of 7.42 ng/mL predicted PR Fraction > 20% [AUC 0.704, (<i>p</i> = 0.05)]. Conclusions: A significant extent of RV fibrosis was mainly detected at surgical sites of RV, affecting RV performance. CMR-FT reveals subtle LV dysfunction in rToF patients, due to decreased performance of the fibrotic RV. Impaired LV function and elevated NTproBNP in rToF reflect a dysfunctional fibrotic RV.Konstantina KaraliKali MakedouAlexandros KallifatidisMatthaios DidagelosGeorge GiannakoulasConstantinos H. DavosTheodoros D. KaramitsosAntonios ZiakasHaralambos KarvounisStavros HadjimiltiadesMDPI AGarticlemyocardial fibrosiscardiac magnetic resonance feature tracking (CMR-FT)Galectin-3Procolagen IIINTproBNPadults with repaired tetralogy fallotMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2101, p 2101 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	myocardial fibrosis cardiac magnetic resonance feature tracking (CMR-FT) Galectin-3 Procolagen III NTproBNP adults with repaired tetralogy fallot Medicine (General) R5-920
spellingShingle	myocardial fibrosis cardiac magnetic resonance feature tracking (CMR-FT) Galectin-3 Procolagen III NTproBNP adults with repaired tetralogy fallot Medicine (General) R5-920 Konstantina Karali Kali Makedou Alexandros Kallifatidis Matthaios Didagelos George Giannakoulas Constantinos H. Davos Theodoros D. Karamitsos Antonios Ziakas Haralambos Karvounis Stavros Hadjimiltiades The Interplay between Myocardial Fibrosis, Strain Imaging and Collagen Biomarkers in Adults with Repaired Tetralogy of Fallot
description	Background: We sought to assess the interplay between right ventricle (RV) fibrosis, biventricular dysfunction based on global longitudinal strain (GLS) analysis, and biomarkers such as Galectin-3 (Gal-3), procollagen type III (PCIII), and NTproBNP. Methods: We studied 35 adult patients with rToF. All patients underwent a cardiac magnetic resonance (CMR) scan including feature tracking for deformation imaging. Blood biomarkers were measured. Results: LGE RV was detected in all patients, mainly at surgical sites. Patients with the highest RV LGE scoring had greater RV dilatation and dysfunction whereas left ventricular (LV) function was preserved. LV GLS correlated with RV total fibrosis score (<i>p</i> = 0.007). A LV GLS value of −15.9% predicted LGE RV score > 8 (AUC 0.754 (<i>p</i> = 0.02)). Neither RV GLS nor biomarker levels were correlated with the extent of RV fibrosis. A cut-off value for NTproBNP of 145.25 pg/mL predicted LGE RV score > 8 points (AUC 0.729, (<i>p</i> = 0.03)). A cut-off value for Gal-3 of 7.42 ng/mL predicted PR Fraction > 20% [AUC 0.704, (<i>p</i> = 0.05)]. Conclusions: A significant extent of RV fibrosis was mainly detected at surgical sites of RV, affecting RV performance. CMR-FT reveals subtle LV dysfunction in rToF patients, due to decreased performance of the fibrotic RV. Impaired LV function and elevated NTproBNP in rToF reflect a dysfunctional fibrotic RV.
format	article
author	Konstantina Karali Kali Makedou Alexandros Kallifatidis Matthaios Didagelos George Giannakoulas Constantinos H. Davos Theodoros D. Karamitsos Antonios Ziakas Haralambos Karvounis Stavros Hadjimiltiades
author_facet	Konstantina Karali Kali Makedou Alexandros Kallifatidis Matthaios Didagelos George Giannakoulas Constantinos H. Davos Theodoros D. Karamitsos Antonios Ziakas Haralambos Karvounis Stavros Hadjimiltiades
author_sort	Konstantina Karali
title	The Interplay between Myocardial Fibrosis, Strain Imaging and Collagen Biomarkers in Adults with Repaired Tetralogy of Fallot
title_short	The Interplay between Myocardial Fibrosis, Strain Imaging and Collagen Biomarkers in Adults with Repaired Tetralogy of Fallot
title_full	The Interplay between Myocardial Fibrosis, Strain Imaging and Collagen Biomarkers in Adults with Repaired Tetralogy of Fallot
title_fullStr	The Interplay between Myocardial Fibrosis, Strain Imaging and Collagen Biomarkers in Adults with Repaired Tetralogy of Fallot
title_full_unstemmed	The Interplay between Myocardial Fibrosis, Strain Imaging and Collagen Biomarkers in Adults with Repaired Tetralogy of Fallot
title_sort	interplay between myocardial fibrosis, strain imaging and collagen biomarkers in adults with repaired tetralogy of fallot
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/7e81e279b62e47858f80691a0b7aa874
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The Interplay between Myocardial Fibrosis, Strain Imaging and Collagen Biomarkers in Adults with Repaired Tetralogy of Fallot

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