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Worst prognosis risk factors in Tetralogy of Fallot
Session:
Posters (Sessão 1 - Écran 4) - Cardiopatias congénitas
Speaker:
Ana Amador
Congress:
CPC 2023
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
20. Congenital Heart Disease and Pediatric Cardiology
Subtheme:
20.6 Congenital Heart Disease – Clinical
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Ana Filipa Amador; Catarina Martins da Costa; João Calvão; Catarina Amaral Marques; André Cabrita; Ana Isabel Pinho; Cátia Oliveira; Luis Daniel Santos; Teresa Pinho; Cristina Cruz; Filipe Macedo
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Background:</strong> Repaired Tetralogy of Fallot (ToF) may present several complications in adult life. We studied our cohort of adult ToF patients to access which risk factors may be related to these complications.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Methods:</strong> We included patients with repaired tetralogy of Fallot with active follow-up between 2000 and 2022 in a single tertiary center. Clinical, analytical, electrocardiography and echocardiography data were collected. <span style="font-size:11.0pt">During follow up (FUP), we considered major adverse cardiovascular events (MACE) as a composite of </span>death, ventricular tachycardia or proposed to pulmonary valve replacement (PVR). </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Results:</strong> Of the 217 eligible patients (male 115 (53%)), 59 (27%) reached the primary outcome (47 PVR, 10 deaths and 3 ventricular tachycardia) at a median follow up of 35 (interquartile range – IQR - 16) years. Transannular patch (event vs no event: 69% vs 49%; p = 0.013) and QRS duration above 160 ms (64% vs 38%; p=0.001) were associated with outcome (figure 1 for Kaplan-Meier curves). Right auricle-right ventricle gradient (34 (20) vs 27 (13) mmHg; p=0.02), B-type natriuretic peptide (57 (99) vs 40 (36) pg/mL; p<0.001) were also predictors of events. Previous shunt (50% vs 42%; p=0.200), Down syndrome (7% vs 5%; p=0.304), gradient pulmonary artery-right ventricle (19 (21) vs 20 (16) mmHg; p=0.589) did not show relation with events. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Conclusion: </strong>In this observational study of patients with ToF, transannular patch history, QRS wide above 160ms, RV systolic pressure, among others, were predictive of events during the follow-up. Prospective clinical trials are needed to confirm this data.</span></span></p>
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