Table 2.
Univariate Association of Demographic, Anatomic, Surgical, CMR, and Arrhythmia Characteristics With All‐Cause Death in the Development Cohort
| Variable | Survivor (n=1147) | Death (n=74) | Univariate Cox model, HR (95% CI) | P value |
|---|---|---|---|---|
| Demographics | ||||
| Age at repair, y | 1.00 (0.30–3.99) | 8.39 (3.23–14.08) | 1.08 (1.06–1.09) | <0.001 |
| Year of TOF repair ≤1985, n (%) | 444 (38.7) | 53 (71.6) | 2.46 (1.48–4.10) | <0.001 |
| Age at CMR, y | 19.8 (13.6–31.5) | 39.2 (25.3–50.5) | 1.06 (1.05–1.08) | <0.001 |
| Time from repair to CMR | 18.4 (12.6–27.8) | 29.3 (18.5–35.6) | 1.07 (1.04–1.09) | <0.001 |
| Sex, male, n (%) | 619 (54.0) | 41 (55.4) | 1.04 (0.66–1.65) | 0.86 |
| BMI at CMR, kg/m2 | 23.5±6.1 | 26.5±6.0 | 1.07 (1.03–1.10) | <0.001 |
| Obese (BMI ≥30), n (%) | <0.001 | |||
| Yes | 160 (13.9) | 21 (28.4) | 2.48 (1.49–4.12) | |
| No | 987 (86.1) | 53 (71.6) | Reference | |
| Diagnosis | ||||
| TOF diagnosis, n (%) | 0.03 | |||
| TOF/PS | 931 (81.2) | 53 (71.6) | Reference | |
| TOF/PA | 216 (18.8) | 21 (28.4) | 1.74 (1.05–2.88) | |
| Genetic anomaly, n (%) | 153 (13.3) | 6 (8.1) | 0.65 (0.28–1.51) | 0.32 |
| Additional cardiovascular anomaly, n (%) | 514 (44.8) | 26 (35.1) | 0.94 (0.58–1.52) | 0.79 |
| MAPCAs | 46 (4.0) | 7 (9.5) | 3.26 (1.50–7.12) | <0.01 |
| Absent pulmonary valve | 22 (1.9) | 0 (0) | — | — |
| Prior procedures | ||||
| Pre‐TOF repair palliative shunt, n (%) | 288 (25.1) | 42 (56.8) | 2.80 (1.76–4.43) | <0.001 |
| TOF repair type, n (%) | <0.01 | |||
| Transannular patch | 619 (54.0) | 24 (32.4) | Reference | |
| Right ventricle‐to‐pulmonary artery conduit | 179 (15.6) | 19 (25.7) | 2.50 (1.37–4.57) | |
| Other | 349 (30.4) | 31 (41.9) | 2.36 (1.39–4.03) | |
| Postrepair cardiac procedures, n (%) | 661 (57.6) | 51 (68.9) | 1.84 (1.12–3.02) | 0.02 |
| Postrepair PVR, n (%) | 674 (58.8) | 42 (56.8) | 1.06 (0.67–1.70) | 0.79 |
| CMR parameters | ||||
| RVEDVi, mL/m2 | 144.2±45.2 | 164.0±62.5 | 1.08 (1.03–1.12)* | <0.001 |
| RVESVi, mL/m2 | 73.1±32.1 | 98.2±51.4 | 1.14 (1.09–1.19)* | <0.001 |
| RV EF, % | 50.4±8.2 | 42.3±10.9 | 0.41 (0.33–0.51)* | <0.001 |
| RV mass index, g/m2 | 32.7±11.4 | 42.7±16.8 | 1.48 (1.30–1.68)* | <0.001 |
| RV mass/volume ratio, g/mL | 0.24±0.08 | 0.27±0.09 | 1.34 (1.07–1.67)† | 0.011 |
| LVEDVi, mL/m2 | 86.2±19.3 | 94.8±28.0 | 1.16 (1.07–1.27)* | <0.001 |
| LVESVi, mL/m2 | 36.7±12.8 | 44.8±20.2 | 1.38 (1.23–1.54)* | <0.001 |
| LV EF, % | 58.0±6.8 | 54.0±9.5 | 0.45 (0.34–0.60)* | <0.001 |
| LV mass, index, g/m2 | 51.6±13.6 | 64.7±21.6 | 1.46 (1.30–1.63)* | <0.001 |
| LV mass/volume ratio, g/mL | 0.61±0.15 | 0.70±0.22 | 1.25 (1.12–1.40)† | <0.001 |
| BVGFI | 49.0±7.9 | 40.3±9.9 | 0.90 (0.88–0.92) | <0.001 |
| RV/LVEDV ratio | 1.72±0.54 | 1.82±0.71 | 1.03 (1.00–1.07)† | 0.09 |
| Arrhythmia data | ||||
| Atrial arrhythmia, n (%)‡ | 108 (9.4%) | 27 (36.5%) | 5.15 (3.16–8.39) | <0.001 |
| Nonsustained VT, n (%)‡ | 190 (16.6%) | 23 (31.1%) | 2.43 (1.48–4.01) | <0.001 |
| Pacemaker, n (%)‡ | 19 (1.7%) | 3 (4.1%) | 2.09 (0.65–6.74) | 0.22 |
| Implantable cardioverter‐defibrillator, n (%)‡ | 78 (6.8%) | 14 (18.9%) | 2.37 (1.30–4.33) | 0.047 |
| Sustained VT n (%)‡ | 33 (2.9%) | 3 (4.1%) | 1.69 (0.53–5.41) | 0.38 |
| QRS duration, ms | 141.5±26.7 | 160.4±26.6 | 1.24 (1.14–1.36) | <0.001 |
BMI indicates body mass index; BVGFI, biventricular global function index; CMR, cardiovascular magnetic resonance imaging; HR, hazard ratio; ICD, implantable cardioverter‐defibrillator; LV, left ventricular; LVEDV, left ventricular end‐diastolic volume; LVEDVi, left ventricular end‐diastolic volume index; LVEF, left ventricular ejection fraction; LVESVi, left ventricular end‐systolic volume index; MAPCAs, major aortopulmonary collateral arteries; PA, pulmonary atresia; PS, pulmonary stenosis; PVR, pulmonary valve replacement; RV, right ventricular; RVEDVi, right ventricular end‐diastolic volume index; RVEF, right ventricular ejection fraction; RVESVi, right ventricular end‐systolic volume index; TOF, tetralogy of Fallot; and VT, ventricular tachycardia.
HR per 10‐unit increase.
HR per 0.1‐unit increase.
Time‐dependent covariate.