The Impact of Preexisting Myocardial Remodeling on Ventricular Function Early after Tetralogy of Fallot Repair

Autor(es)

Knoll Farah, Maria Cecilia ^[1] ; Pinheiro Castro, Claudia Regina ; Moreira, Valeria de Melo ; Binotto, Maria Angelica ; Guerra, Vitor Coimbra ; Riso, Arlindo de Almeida ; Marcial, Miguel Barbero ; Lopes, Antonio Augusto ; Mathias, Jr., Wilson ; Aiello, Vera Demarchi ^[2]

Afiliação do(s) autor(es)

^[1] Univ Mato Grosso, Sch Med, Hlth & Biol Sci Ctr, Cuiaba - Brazil

^[2] Univ Sao Paulo, Sch Med, Pathol Lab, Heart Inst InCor, BR-05508 Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Journal of the American Society of Echocardiography; v. 23, n. 9, p. 912-918, SEP 2010.
• Citações Web of Science: 11

Resumo

Background: Twenty-three patients (median age 23 months) who underwent Fallot's tetralogy repair were investigated prospectively to detect a possible association between histopathologic myocardial remodeling and echocardiographic findings of systolic or diastolic ventricular dysfunction. Methods: Intraoperatively resected infundibular bands and subendocardial biopsy samples from the right ventricle (RV) and left ventricle were obtained for histopathologic evaluation. Tissue Doppler echocardiographic interrogation of the ventricles was performed before surgery and in the postoperative period. Results: Histopathologic data revealed hypertrophy of the RV cardiomyocytes and increased interstitial collagen in both ventricles. Mean values of RV isovolumic acceleration decreased significantly at the third evaluation compared with the preoperative values (P = .006). RV myocardial fibrosis greater than 8.3% was associated with a probability of altered E' of at least 0.7 (odds ratio = 2.31). Conclusion: Preoperative histologic myocardial remodeling influenced the postoperative RV function in this group of patients with late repair. Further studies are necessary to evaluate the myocardium in younger patients and to define its influence in the long-term follow-up. (J Am Soc Echocardiogr 2010;23:912-8.) (AU)

• Processo FAPESP: 05/01476-2 - Disfunção ventricular no pós-operatório da intervenção cirúrgica para correção dos defeitos congênitos da Tetralogia de Fallot: estudo de correlação clínica e anatomopatológica
• Beneficiário: Vera Demarchi Aiello
• Modalidade de apoio: Auxílio à Pesquisa - Regular