Left ventricular function in adults with mild pulmonary insufficiency lateafter Fallot repair

Objective-To assess left ventricular function in adult Fallot patients with residual pulmonary regurgitation. Setting-The radiology department of a tertiary referral centre. Patients-14 patients with chronic pulmonary regurgitation and right ventric ular volume overload after repair of tetralogy of Fallot and 10 healthy sub jects were studied using magnetic resonance imaging. Main outcome measures-Biventricular volumes, global biventricular function, and regional left ventricular function were assessed in all subjects. Results-The amount of pulmonary regurgitation in patients (mean (SD)) was 2 5 (18)% of forward flow and correlated significantly with right ventricular enlargement (p < 0.05). Left ventricular end diastolic volume was decrease d in patients (78 (11) v 88 (10) ml/m(2) ; p < 0.05), ejection fraction was not significantly altered (59 (5)% v 55 (7)%; NS). No significant correlat ion was found between pulmonary regurgitation and left ventricular function . Overall left ventricular end diastolic wall thickness was significantly l ower in patients (5.06 (0.72) v 6.06 (1.06) mm; p < 0.05), predominantly in the free wall. At the apical level, left ventricular systolic wall thicken ing was 20% higher in Fallot patients (p < 0.05). Left ventricular shape wa s normal. Conclusions-Adult Fallot patients with mild chronic pulmonary regurgitation and subsequent right ventricular enlargement showed a normal left ventricu lar shape and global function. Although the left ventricular free wall had reduced wall thickness, compensatory hypercontractility of the apex may con tribute to preserved global function.