Proteomic Profile Linked to Right Ventricular Dilation After Tetralogy of Fallot Repair

In a cross-sectional study of 14 adolescents with repaired tetralogy of Fallot, researchers compared serum proteomics with cardiac magnetic resonance measures of right ventricular size. Those with greater dilation had differences in pathways related to glucose and fatty acid metabolism and antioxidant response, despite similar ejection fraction.

Study included 14 adolescents after tetralogy of Fallot repair.
Greater RV dilation was associated with altered serum protein pathways.
RV ejection fraction was similar between volume groups.
Findings are exploratory and require validation in larger studies.

Right ventricular (RV) dilation can develop after surgical repair of tetralogy of Fallot (TOF), but circulating proteins associated with this remodeling are not well characterized. In this proof-of-concept cross-sectional study, investigators assessed 14 adolescents undergoing clinically indicated cardiac magnetic resonance (CMR) at one children’s hospital. Participants were grouped by indexed RV end-diastolic volume (RVEDVi), and serum proteins were analyzed using untargeted proteomics.

Nine participants in the higher-volume group had a median RVEDVi of 146 mL/m² (IQR 139–164), compared with 114 mL/m² (IQR 104–130) among five participants in the lower-volume group. Indexed RV stroke volume was higher in the dilation group (85 vs 59 mL/m²; p=0.023), while RV ejection fraction was similar. The group with greater dilation showed altered protein regulation across several pathways, including glucose and fatty acid metabolism and antioxidant response.

The findings suggest that CMR-defined RV dilation may be accompanied by a distinct serum proteomic profile, potentially reflecting metabolic and oxidative-stress changes. The small sample, adolescent population, and cross-sectional design limit interpretation; the study does not establish whether these protein differences predict outcomes or could guide treatment. The authors describe the results as hypothesis-generating and call for larger studies before proteomics is used in prognostication or clinical decision-making.

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Source

Pediatric Research: A complementary proteomics and cardiac magnetic resonance approach to characterize right ventricular remodeling after tetralogy of Fallot repair ↗

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