Right ventricular (RV) late gadolinium enhancement (LGE) occurs due to surgical scarring and RV remodeling, and has been shown to be associated with clinical outcomes in Tetralogy of Fallot (TOF). However, it is not known if cardiovascular magnetic resonance (CMR) LGE extent progresses over time, and therefore, it is not known if serial reassessment of LGE is necessary. We determined the rate of progression in the extent of RV LGE on serial CMR examinations in repaired TOF. Retrospective review of 127 patients after TOF repair (49% male, median age at first CMR 18.9 years (Interquartile range (IQR) 13.3,27.0) who had at least two CMRs (median follow-up duration of 4.0 years (IQR 2.1,5.9)) was performed. 84/127 patients had no interventions between serial CMRs (Group 1) while 43/127 patients had transcatheter or surgical intervention between CMRs (Group 2). The extent of RV LGE was assessed using 2 methods: a semiquantitative RV LGE score and a quantitative RV LGE extent expressed as % of RV mass. Mixed effects linear regression modeling to estimate changes in LGE over time. RV LGE was present in all patients on the first CMR. % RV LGE extent and LGE score did not increase over time in either patient group. The mean 5 year rates of change were small and negative for both % RV LGE extent [− 2.3 (95% CI − 2.9, − 1.8, p < 0.001) in Group 1, and − 1.9 (95% CI − 3.2, − 0.7, p = 0.004) in Group 2], and RV LGE score [− 0.9 (95% CI − 1.1, − 0.6, p < 0.001) in Group 1, and − 0.5 (95% CI − 1.1, − 0.0, p = 0.047) in Group 2]. In this serial CMR evaluation of children and adults with repaired TOF, no significant progression in the extent of RV LGE was seen on intermediate term follow-up. Given recent concerns regarding the safety of gadolinium-based contrast agents, frequent assessment of LGE may not be necessary in follow-up.

中文翻译：

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修复法洛四联症晚期钆增强程度的纵向变化：连续 CMR 的回顾性分析

右心室 (RV) 晚期钆增强 (LGE) 是由手术瘢痕形成和 RV 重塑引起的，并且已被证明与法洛四联症 (TOF) 的临床结果相关。然而，尚不清楚心血管磁共振 (CMR) LGE 的程度是否会随着时间的推移而进展，因此，是否有必要对 LGE 进行连续重新评估尚不清楚。我们确定了修复 TOF 中连续 CMR 检查中 RV LGE 范围的进展率。对 TOF 修复后 127 名患者（49% 男性，第一次 CMR 的中位年龄 18.9 岁（四分位距 (IQR) 13.3,27.0）至少有两次 CMR（中位随访时间为 4.0 年（IQR 2.1,5.9））的回顾性研究)) 进行。84/127 名患者在连续 CMR 之间没有干预（第 1 组），而 43/127 名患者在 CMR 之间进行了经导管或手术干预（第 2 组）。使用 2 种方法评估 RV LGE 的范围：半定量 RV LGE 评分和定量 RV LGE 范围，表示为 RV 质量的百分比。用于估计 LGE 随时间变化的混合效应线性回归模型。在第一次 CMR 中，所有患者都存在 RV LGE。在任一患者组中，% RV LGE 范围和 LGE 评分均未随时间增加。% RV LGE 范围的平均 5 年变化率很小且为负 [- 2.3 (95% CI - 2.9, - 1.8, p < 0.001) 在第 1 组和 - 1.9 (95% CI - 3.2, - 0.7 , p = 0.004) 在第 2 组] 和 RV LGE 评分 [− 0.9 (95% CI − 1.1, − 0.6, p < 0.001) 在组 1, 和 − 0.5 (95% CI − 1.1, − 0.0, p = 0.047) 在第 2 组]。在对 TOF 修复的儿童和成人进行的这项连续 CMR 评估中，在中期随访中未观察到 RV LGE 范围的显着进展。鉴于最近对基于钆造影剂的安全性的担忧，在随访中可能没有必要频繁评估 LGE。