ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2021
Moving beyond size: vorticity and energy loss are correlated with right ventricular dysfunction and exercise intolerance in repaired Tetralogy of Fallot.
Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 35 citations in OpenAlex.
- Exercise Testing and Counseling in Patients with Tetralogy of Fallot: A Guide for the Pediatric and Congenital Cardiologist.Pediatric cardiology · 2026Review
- Discovery Beyond the "Undiscovered Country": Re-Exploring the Right Ventricle Through Metabolomics and Cardiac Magnetic Resonance.JACC. Asia · 2026Article
- 4D Flow Yields Similar Clinical Results Compared To 2D Phase Contrast for Decision Making Regarding Pulmonary Valve Replacement in Repaired Tetralogy of Fallot.Pediatric cardiology · 2026Article
- Longitudinal Intracardiac Right Ventricular Flow Analysis in Infants With Hypoplastic Left Heart Syndrome in Interstage I Using Novel Doppler Velocity Reconstruction.Journal of the American Heart Association · 2025Article
- Increased Diastolic Energy Loss Associated with Cardiac Events in Adults with Pulmonary Atresia Suffering from Intact Ventricular Septum.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2025Article
- Ferumoxytol-enhanced cardiovascular magnetic resonance imaging: applications and technical advances.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2025Review
- Understanding Right Heart Flow: Implications for Interatrial Shunt Device Therapy in Heart Failure.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Review
- Energy loss and adults with congenital heart disease: a novel marker of cardiac workload beyond right ventricular size.Cardiovascular diagnosis and therapy · 2024Review
- Right Ventricular Restrictive Physiology Is Associated With Right Ventricular Direct Flow From 4D Flow CMR.JACC. Asia · 2024Article
- Tetralogy of Fallot regurgitation energetics and kinetics: an intracardiac flow analysis of the right ventricle using computational fluid dynamics.The international journal of cardiovascular imaging · 2024Article
- Novel Techniques in Imaging Congenital Heart Disease: JACC Scientific Statement.Journal of the American College of Cardiology · 2024Review
- Society for Cardiovascular Magnetic Resonance 2022 Cases of SCMR case series.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2024Review
- Fetal and neonatal echocardiographic analysis of biomechanical alterations for the systemic right ventricle heart.PloS one · 2024Article
- Enhanced echocardiographic assessment of intracardiac flow in congenital heart disease.PloS one · 2024Article
- 4D-Flow MRI intracardiac flow analysis considering different subtypes of pulmonary hypertension.Pulmonary circulation · 2023Article
- Intracardiac Flow Analysis of the Right Ventricle in Pediatric Patients With Repaired Tetralogy of Fallot Using a Novel Color Doppler Velocity Reconstruction.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2023Article
- 2021-2022 state of our JCMR.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2022Review
- Statistical shape modeling reveals the link between right ventricular shape, hemodynamic force, and myocardial function in patients with repaired tetralogy of Fallot.American journal of physiology. Heart and circulatory physiology · 2022Article
- Intraventricular Flow Simulations in Singular Right Ventricles Reveal Deteriorated Washout and Low Vortex Formation.Cardiovascular engineering and technology · 2022Article
- Ventricular flow analysis and its association with exertional capacity in repaired tetralogy of Fallot: 4D flow cardiovascular magnetic resonance study.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThe global effect of chronic pulmonary regurgitation (PR) on right ventricular (RV) dilation and dysfunction in repaired Tetralogy of Fallot (rTOF) patients is well studied by cardiovascular magnetic resonance (CMR). However, the links between PR in the RV outflow tract (RVOT), RV dysfunction and exercise intolerance are not clarified by conventional measurements. Not all patients with RV dilation share the same intracardiac flow characteristics, now measurable by time resolved three-dimensional phase contrast imaging (4D flow). In our study, we quantified regional vorticity and energy loss in rTOF patients and correlated these parameters with RV dysfunction and exercise capacity.
methodsrTOF patients with 4D flow datasets were retrospectively analyzed, including those with transannular/infundibular repair and conduit repair. Normal controls and RV dilation patients with atrial-level shunts (Qp:Qs > 1.2:1) were included for comparison. 4D flow was post-processed using IT Flow (Cardioflow, Japan). Systolic/diastolic vorticity (ω, 1/s) and viscous energy loss (VEL, mW) in the RVOT and RV inflow were measured. To characterize the relative influence of diastolic vorticity in the two regions, an RV Diastolic Vorticity Quotient (ω
results58 rTOF patients, 28 RV dilation patients and 12 controls were included. RV-DVQ, RVOT-VQ, and RVOT-EQ were highest in rTOF patients with severe PR compared to rTOF patients with non-severe PR, RV dilation and controls (p < 0.001). RV-DVQ positively correlated with RV end-diastolic volume (0.683, p < 0.001), PR fraction (0.774, p < 0.001) and negatively with RV ejection fraction (- 0.521, p = 0.003). Both RVOT-VQ, RVOT-EQ negatively correlated with VO
conclusionsIn rTOF patients, vorticity and energy loss dominate the RVOT compared to tricuspid inflow, correlating with RV dysfunction and exercise intolerance. These 4D flow-based measurements may be sensitive biomarkers to guide surgical management of rTOF patients.
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