International multicenter tetralogy of Fallot registry: identifying predictors of adverse outcomes using cardiac MRI parameters

Although survival of patients with repaired tetralogy of Fallot (TOF) into adulthood exceeds 90%, hemodynamic and electrophysiologic abnormalities contribute to substantial morbidity in this population. The rate of late complications such as exercise intolerance, heart failure, tachyarrhythmias, and death accelerates in the third decade of life. However, identifying predictors for adverse outcomes remains difficult, as the event rates for major outcomes, such as ventricular tachycardia (VT) and death are low. Small, single center studies have suggested that cardiac magnetic resonance (CMR) measures of ventricular size and function are independent predictors of major adverse clinical outcomes. However, the small number of outcome events and the single center study design limit general acceptance of these findings. A multicenter registry may allow identification of generalizable predictors of major adverse outcomes and will provide opportunities for robust analyses to address clinically relevant questions in this population.