Evidence map›Paper›PMID 40122390›Full record

ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2025

Characteristics of left ventricular dysfunction in repaired tetralogy of Fallot: A multi-institutional deep learning analysis of regional strain and dyssynchrony.

Brendan T Crabb, Rahul S Chandrupatla, Evan M Masutani, Sophie Y Wong, Sachin Govil, Silvia Montserrat, Susana Prat-González, Julián Vega-Adauy, Melany Atkins, Daniel Lorenzatti and 9 more

Abstract readMulticenter Study
In one paragraph

Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Brendan T CrabbUniversity of California San Diego, La Jolla, California, USA. Electronic address: b2crabb@health.ucsd.edu.
Rahul S ChandrupatlaUniversity of California San Diego, La Jolla, California, USA. Electronic address: rchandru@health.ucsd.edu.
Evan M MasutaniUniversity of California San Diego, La Jolla, California, USA. Electronic address: emasutan@health.ucsd.edu.
Sophie Y WongUniversity of California San Diego, La Jolla, California, USA. Electronic address: soyou@health.ucsd.edu.
Sachin GovilUniversity of California San Diego, La Jolla, California, USA. Electronic address: sagovil@eng.ucsd.edu.
Silvia MontserratHospital Clínic Barcelona, Barcelona, Spain. Electronic address: smontser@clinic.cat.
Susana Prat-GonzálezHospital Clínic Barcelona, Barcelona, Spain. Electronic address: suprat@clinic.cat.
Julián Vega-AdauyChilean Institute of Cardiac Imaging, Santiago, Chile. Electronic address: julianvega@gmail.com.
Melany AtkinsInova Fairfax Hospital, Fairfax, Virginia, USA. Electronic address: melanyatkins@gmail.com.
Daniel LorenzattiHospital Clínic Barcelona, Barcelona, Spain. Electronic address: danilorenzatti@gmail.com.
Chiara ZocchiSan Donato Hospital, Arezzo, Italy. Electronic address: zocchichiara@gmail.com.
Elena PanaioliNecker Enfants-Malades Hospital, Université de Paris, Paris, France. Electronic address: epanaioli@gmail.com.
Nathalie BoddaertNecker Enfants-Malades Hospital, Université de Paris, Paris, France. Electronic address: Nathalie.boddaert@aphp.fr.
Laith AlshawabkehUniversity of California San Diego, La Jolla, California, USA. Electronic address: lalsh@health.ucsd.edu.
Lewis HahnUniversity of California San Diego, La Jolla, California, USA. Electronic address: lehahn@health.ucsd.edu.
Sanjeet HegdeUniversity of California San Diego, La Jolla, California, USA; Rady Children's Hospital San Diego, San Diego, California, USA. Electronic address: shegde@rchsd.org.
Andrew D McCullochUniversity of California San Diego, La Jolla, California, USA. Electronic address: amcculloch@ucsd.edu.
Francesca RaimondiNecker Enfants-Malades Hospital, Université de Paris, Paris, France. Electronic address: Francesca.raimondi@gmail.com.
Albert HsiaoUniversity of California San Diego, La Jolla, California, USA. Electronic address: a3hsiao@health.ucsd.edu.

Funding

The Cardiac Atlas ProjectR01HL121754 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MCCULLOCH, ANDREW D., OMENS, JEFFREY H. · 2014 to 2023
$5.0M
Traning Clinical Scientists in Radiological ImagingT32EB005970 · NIBIB · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Eric Y Chang, Rebecca Ann Rakow-Penner · 2007 to 2026
$3.2M
NHLBI NIH HHS R01 HL121754NIBIB NIH HHS T32 EB005970NIH BTC T32
6 · The paper itself

Abstract

backgroundPatients with repaired tetralogy of Fallot (rTOF) are commonly followed with cardiovascular magnetic resonance (CMR) imaging and frequently develop right ventricular (RV) dysfunction, which can be severe enough to impact left ventricular (LV) function in some patients. In this study, we sought to characterize patterns of LV dysfunction in this patient population using deep learning synthetic strain (DLSS), a fully automated deep learning algorithm capable of measuring regional LV strain and dyssynchrony.

methodsWe retrospectively collected cine steady-state free precession (SSFP) MRI images from a multi-institutional cohort of 198 patients with rTOF and 21 healthy controls. Using DLSS, we measured LV strain and strain rate across 16 American Heart Association segments from short-axis cine SSFP images and compared these values to controls. We then performed a clustering analysis to identify unique patterns of LV contraction, using segmental peak strain and several measures of dyssynchrony. We further characterized these patterns by assessing their relationship to traditional MRI metrics of volume and function. Lastly, we assessed their impact on subsequent progression to pulmonary valve replacement (PVR) through a multivariate analysis.

resultsOverall, patients with rTOF had decreased septal radial strain, increased lateral wall radial strain, and increased dyssynchrony relative to healthy controls. Clustering of rTOF patients identified four unique patterns of LV contraction. Most notably, patients in cluster 1 (n = 39) demonstrated an LV contraction pattern with paradoxical septal wall motion and severely reduced septal strain. These patients had significantly elevated RV end-diastolic volume relative to clusters 3 and 4 (153 ± 34 vs 127 ± 34 and 126 ± 31 mL/m

conclusionPatients with rTOF demonstrate four unique patterns of LV dysfunction. Most commonly, but not exclusively, LV dysfunction is characterized by septal wall motion abnormalities and severely reduced septal strain. Patients with this pattern of LV dysfunction had concomitant RV dysfunction and rapid progression to PVR.

Indexed as

Cardiac Surgical ProceduresDeep LearningImage Interpretation, Computer-AssistedMagnetic Resonance Imaging, CineTetralogy of FallotVentricular Dysfunction, LeftVentricular Function, LeftAdolescentAdultCase-Control StudiesChildFemaleHumansMalePredictive Value of TestsRetrospective StudiesCardiovascular magnetic resonance (CMR)Congenital heart diseaseDeep learningMyocardial strainTetralogy of Fallot

Identifiers

PMID40122390
PMCPMC12182814

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.