Assessment of Left Ventricular function and Aortic blood flow in children with Tetralogy of Fallot (TOF) attending two health institutions in Enugu Metropolis

Abstract

Background: Children with Tetralogy of Fallot (TOF) usually present with right heart abnormalities, however much is not known if these children presents with left ventricular dysfunction. Objectives: This article is aimed to ascertain the left ventricular function of children with TOF compared with those without any congenital heart disease. It also elicits the correlation if any, between left ventricular mass and descending aorta blood flow. Methods: This is a comparative study involving 91 children with TOF with age and gender matched control. Echocardiographic evaluation of left ventricular function and their parameters in children with TOF were compared with controls. The data was analyzed with the IBM SPSS statistics for windows, version 20 (IBM Corp, Chicago). Results: The mean LVIDd of subjects without TOF, 25.7±10.1 was higher than that of those with TOF, 21.2±7.1 and the difference in mean was found to be statistically significant, (Student t=3.455, p=0.001). The mean EF of respondents with TOF, 61.9±19.3 was lower than that of subjects without TOF, 67.2±9.3 and the difference in mean was found to be statistically significant, (Student t=2.333, p=0.021). The mean FS of respondents with TOF, 43.1±16.6 was significantly lower than that of respondents without FS 46.7±8.2 (Student t=3.519, p=0.001). The mean velocity of respondents without TOF, 1.3±0.3 was significantly higher than that of respondents with TOF, 1.2±0.2. (Student t=4.199, p<0.001).For respondents who had TOF, there was a weak negative correlation between LV mass and velocity, increases with LV mass correlates with decreases in velocity but this was not found to be statistically significant, (n=63, r=-0.214, p=0.093). Conclusion: Though it is generally known that children with TOF present with right ventricular dysfunction, however this study has shown that they also present with various degrees of left ventricular systolic abnormalities. Though left ventricular systolic function in children with TOF is lower than that in normal children, all values still fall within normal refrence ranges.