@Article{chd.2024.051837,
AUTHOR = {Hiroki Nagamine, Masaru Miura, Jun Maeda, Takumi Nishiki, Maasa Sato, Fumie Takechi, Shigeru Tateno, Tomoko Ishizu, Yumi Shiina, Ken Kato, Hiroshi Ono, Hiroyuki Yamagishi, Koichiro Niwa},
TITLE = {Prospective Cohort Research of Aortic Root Dilatation after Surgical Repair in Adults with Tetralogy of Fallot (TRANSIT)},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {19},
YEAR = {2024},
NUMBER = {4},
PAGES = {351--362},
URL = {http://www.techscience.com/schd/v19n4/58473},
ISSN = {3071-1738},
ABSTRACT = { <b>Background:</b> Aortic root dilatation occurs in adults with tetralogy of Fallot (TOF) after surgical repair, but the longitudinal changes are unclear. The main research aim is to determine the annual dilatation rate of aorta in adults with repaired TOF. <b>Methods:</b> The present, multicentric, prospective cohort study assessed the rate of aortic diameter change in adults aged 20 years or older with TOF, including pulmonary artery atresia, who underwent surgical repair. Clinical data, focusing on echocardiograms, were collected at three-year intervals from seven hospitals. <b>Results:</b> In total, 104 patients (58 males; median age: 29 years) were enrolled. The actual Valsalva sinus (VS) diameter was 34.3 ± 5.8 (mean ± standard deviation) and 36.1 ± 6.0 mm at the initial and final examinations, respectively, and the annual dilatation rate was 0.64 (0.07, 1.33) (median, interquartile) mm/year. The corrected diameter at the respective examination was 21.3 ± 3.8 and 22.2 ± 3.7 mm/m<sup>2</sup>, and the annual dilation rate was 0.28 (−0.21, 0.76) mm/m<sup>2</sup>/year. Multiple regression analysis showed that factors significant associated with dilatation rate of actual VS diameter were the diastolic blood pressure (standardized coefficient −0.22; <i>p</i> = 0.04), cardiothoracic ratio (0.28; 0.02), and the ratio of early mitral valve inflow velocity to early diastolic annular velocity (E/e′) ratio (0.31; 0.004). Factors significantly associated with corrected VS diameter were diastolic blood pressure (−0.25; 0.02) and the E/e′ ratio (0.34; 0.001). <b>Conclusions:</b> In adults with repaired TOF, the rate of dilatation of the aortic diameter was associated with decreased diastolic blood pressure and left ventricular diastolic dysfunction, possibly reflecting decreased aortic wall elasticity.},
DOI = {10.32604/chd.2024.051837}
}