MR Images Show Long-Term Issues After Correcting Congenital Heart Disease

Through MRI use, University of Kentucky researchers have shown that adults who received corrective surgery for the most common serious form of congenital heart disease as infants are susceptible to heart failure in adulthood, according to a study recently published in the European Heart Journal.

The University of Kentucky collaborated with several academic institutions to determine whether patients with repaired tetralogy of Fallot suffer from cardiac dyssynchrony, or an uncoordinated heart contraction brought on by a disruption in the heart’s electrical system known as a right bundle block. Through cardiac MRI technology, a research team quantified the location and extent of dyssychrony in the hearts of healthy control subjects and patients with repaired tetralogy of Fallot. By observing patterns of heart contractions through MRI use, the researchers identified dyssychrony in specific regions of the heart in the patients with tetralogy of Fallot. Their goal is to ultimately understand whether this dyssynchrony leads to cardiac failure long term and whether a pacemaker could potentially be used as a way to reverse the dyssynchrony and improve mortality in patients with tetralogy of Fallot.

“The goal of our research is to use imaging to change the way we practice medicine and ultimately improve lives,” says Brandon Fornwalt, MD, PhD, an assistant professor and researcher in the departments of pediatrics, biomedical engineering, electrical and computer engineering, physiology, and cardiology at the University of Kentucky and a researcher on the study.

Tetralogy of Fallot is the most common serious form of congenital heart disease. The mortality rate of patients with tetralogy of Fallot triples 25 years after the initial surgery, and heart failure accounts for two-thirds of those deaths. In most cases, the surgical repair of tetralology of Fallot creates a dyssynchrony, which may play a role in the development of heart failure in these patients and could potentially be treated with a pacemaker. However, significant research will be required to investigate the pacemaker as a potential treatment option.