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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Obesity in Repaired Tetralogy of Fallot: Implications for Symptoms, Right Ventricular Assessment, and Pulmonary Valve Replacement

  • Giovanni Di Salvo1
  • Elettra Pomiato1
  • Francesca Marino2
  • Yara Alras3
  • Ayat Shoaib Shah3
  • Francesco Prati1
  • Domenico Galzerano4
  • Valeria Pergola4
4 affiliations
  1. 1Pediatric Cardiology and Adult Congenital Heart Disease, Department of Child and Woman Health, University of Padua, 35128 Padua, Italy
  2. 2Department of Clinical Medicine and Surgery, Section of Endocrinology, University ‘Federico II’ of Naples, 80131 Naples, Italy
  3. 3College of Medicine, Al Faisal Medical University, Riyadh 11533, Saudi Arabia
  4. 4Heart Center, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
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Abstract

Obesity complicates assessment after repair of tetralogy of Fallot (rTOF) because it can influence symptoms, exercise performance, ventricular remodeling, and the normalization of ventricular measurements. This narrative review examines the direct rTOF evidence, almost all observational, and its implications for pulmonary valve replacement (PVR) decision-making. Obesity is present in approximately 15–20% of patients (12–26% across the cohorts reviewed). In studies using absolute, height-indexed, or ideal-BSA-indexed volumes, obesity was associated with larger biventricular volumes and lower ventricular ejection fractions, and the RV volume association persisted after adjustment for PR in one study. These findings have implications for the interpretation of cardiac findings in patients with moderate-to-severe PR after rTOF. Decisions are best made by integrating all findings, with extra attention to patients with obesity. We propose an integrated assessment of symptoms, rhythms, exercise findings, and ventricular measurements.

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Cite

BibTeXRIS
BibTeX
@article{salvo2026obesity,
  title = {{Obesity in Repaired Tetralogy of Fallot: Implications for Symptoms, Right Ventricular Assessment, and Pulmonary Valve Replacement}},
  author = {Giovanni Di Salvo and Elettra Pomiato and Francesca Marino and Yara Alras and Ayat Shoaib Shah and Francesco Prati and Domenico Galzerano and Valeria Pergola},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = nov,
  doi = {10.3390/jcm15218487},
  url = {https://www.mdpi.com/2077-0383/15/21/8487},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Obesity in Repaired Tetralogy of Fallot: Implications for Symptoms, Right Ventricular Assessment, and Pulmonary Valve Replacement
AU  - Giovanni Di Salvo
AU  - Elettra Pomiato
AU  - Francesca Marino
AU  - Yara Alras
AU  - Ayat Shoaib Shah
AU  - Francesco Prati
AU  - Domenico Galzerano
AU  - Valeria Pergola
PY  - 2026
DA  - 2026/11/01
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218487
UR  - https://www.mdpi.com/2077-0383/15/21/8487
AB  - Obesity complicates assessment after repair of tetralogy of Fallot (rTOF) because it can influence symptoms, exercise performance, ventricular remodeling, and the normalization of ventricular measurements. This narrative review examines the direct rTOF evidence, almost all observational, and its implications for pulmonary valve replacement (PVR) decision-making. Obesity is present in approximately 15–20% of patients (12–26% across the cohorts reviewed). In studies using absolute, height-indexed, or ideal-BSA-indexed volumes, obesity was associated with larger biventricular volumes and lower ventricular ejection fractions, and the RV volume association persisted after adjustment for PR in one study. These findings have implications for the interpretation of cardiac findings in patients with moderate-to-severe PR after rTOF. Decisions are best made by integrating all findings, with extra attention to patients with obesity. We propose an integrated assessment of symptoms, rhythms, exercise findings, and ventricular measurements.
SN  - 2077-0383
ER  -