Novel analytical application of the pressure phase plane for evaluating pulmonary artery wave reflection in surgically repaired tetralogy of Fallot

BackgroundPulmonary artery (PA) wave reflection is a key determinant of right ventricular (RV) afterload. RV function is the most important factor determining long-term prognosis in patients with surgically repaired tetralogy of Fallot (rTOF). This study aimed to evaluate PA wave reflection in rTOF using RV pressure phase plane (PPP) analysis, and to identify the clinical, morphological, and hemodynamic characteristics associated with increased PA wave reflection in patients with rTOF. MethodsAugmentation pressure (AugPr) during late systole was quantified using the inflection point of systolic dP/dt on the PPP. The ratio of AugPr to RV systolic pressure (RVSP) was defined as the AugPr index