• Gabriele Egidy Assenza, Daiana Cassater, Michael Landzberg, Tal Geva, Jenna Schreier, Dionne Graham, Massimo Volpe, Nancy Barker, Katherine Economy, and Anne Marie Valente.
• Department of Cardiology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, "Sapienza Universita' di Roma" University, Rome, Italy.
• Int. J. Cardiol. 2013 Oct 3; 168 (3): 1847-52.

ObjectivesThe aim of this study was to better understand the quantitative volumetric changes associated with pregnancy in women with repaired tetralogy of Fallot (TOF), utilizing sequential cardiovascular magnetic resonance (CMR) imaging.BackgroundAn increasing number of women with repaired TOF are reaching childbearing age. Limited echocardiographic studies suggest accelerated remodeling of the right ventricle (RV) in women with repaired TOF after pregnancy.MethodsSequential CMRs from a group of women with repaired TOF who completed pregnancy and from a matched comparison group of nulliparous women with repaired TOF were evaluated. The two groups were matched according to baseline QRS duration, RV end-diastolic volume (EDV), age at CMR and time between CMRs. Longitudinal change of CMR parameters was compared between the groups.ResultsThirteen women (mean age 26.6 ± 7.4 years) with repaired TOF who completed pregnancy and 26 nulliparous women with repaired TOF (mean age 22.6 ± 8.0 years) were included in this analysis. The rate of increase of RV EDV in the pregnancy group was higher than the comparison group (4.1 ± 1.1 ml/m(2)/year vs. 1.6 ± 0.6 ml/m(2)/year, p=0.07). RV EF did not change significantly in either group. No definitive interaction between degree of pulmonary regurgitation and increase of RV EDV was identified.ConclusionsWomen with repaired TOF who have completed pregnancy appear to experience an accelerated rate of right ventricular remodeling, defined as an increase in end-diastolic volume; however RV systolic function does not deteriorate. Further investigations with a prospective study design, larger cohorts, and longer follow-up are needed to confirm these initial observations.Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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