Departments of Coronary Artery Disease and Structural Heart Diseases, Interventional Cardiology and Angiology, Cardiomyopathy, and Radiology, Cardiac Magnetic Resonance Unit, Institute of Cardiology, ul Alpejska 42, 04-628 Warsaw, Poland.
Purpose:To compare indexed right ventricular (RV) end-diastolic volume (RVEDVi) and the ratio of RV volume to left ventricular (LV) volume (RV/LV ratio) in prediction of significant pulmonary regurgitation (PR) after tetralogy of Fallot (TOF) repair and to assess sex differences in the RV/LV ratio.Materials and Methods:The ethics committee approved this retrospective single-center study, and patients or their parents or guardians signed written informed consent. RVEDVi, RV/LV ratio, and PR were measured with the use of magnetic resonance imaging in 155 consecutive patients with repaired TOF (mean age, 29.2 years±10.9 [standard deviation]; 98 [63.2%] male and 57 [36.8%] female patients). PR fraction of 20% or greater was considered significant. The capability of the RVEDVi and that of the RV/LV ratio for prediction of significant PR were compared by using logistic regression analysis and receiver operating characteristic curve analysis.Results:RVEDVi was significantly higher in male (162.8 mL/m(2)±50.4) than in female (138.2 mL/m(2)±37.5) patients (P = .001). Conversely, the RV/LV ratio was similar in both sexes (1.82±0.56 [male] vs 1.69±0.46 [female], P = .13) both in the entire cohort and after excluding patients with significant (≥ 30 mm Hg) RV outflow tract gradient and/or other residual hemodynamic abnormalities (P = .63). Receiver operating characteristic analysis revealed better discrimination of significant (≥ 20%) from insignificant (<20%) PR with the use of the RV/LV ratio than with RVEDVi (area under the receiver operating characteristic curve, 0.937 [model 4] vs 0.849 [model 1], P = .01). In multivariate analysis, the only independent predictor of PR fraction was the RV/LV ratio.Conclusion:The RV/LV ratio is more accurate than the RVEDVi in differentiation of significant from insignificant PR. After TOF repair, female and male patients have similar RV/LV ratios despite significant differences in RVEDVi between the sexes.© RSNA, 2012Supplemental material:http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120051/-/DC1.