Magalie Ladouceur1, Alban Redheuil2, Gilles Soulat3, Christophe Delclaux4, Michel Azizi5, Mehul Patel6, Gilles Chatellier7, Antoine Legendre8, Laurence Iserin8, Younes Boudjemline8, Damien Bonnet9, Elie Mousseaux3. 1. INSERM U970, Paris Cardiovascular Research Centre, Université Paris-Descartes, France; Department of Paediatric Cardiology, Centre de référence des Malformations Cardiaques Congénitales Complexes, M3C, Hôpital Necker Enfants malades, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, Paris, France; Adult Congenital Heart Disease Unit, Cardiology Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, France. Electronic address: magalie.ladouceur@aphp.fr. 2. Department of Cardiovascular Radiology, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, France. 3. INSERM U970, Paris Cardiovascular Research Centre, Université Paris-Descartes, France; Department of Cardiovascular Radiology, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, France. 4. Service de Physiologie - Clinique de la Dyspnée, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, France. 5. Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Centre d'Investigation Clinique, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, F-75015 Paris, France. 6. Baylor College of Medicine, Houston, TX, USA. 7. Clinical Research Unit, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, France. 8. Department of Paediatric Cardiology, Centre de référence des Malformations Cardiaques Congénitales Complexes, M3C, Hôpital Necker Enfants malades, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, Paris, France; Adult Congenital Heart Disease Unit, Cardiology Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, France. 9. Department of Paediatric Cardiology, Centre de référence des Malformations Cardiaques Congénitales Complexes, M3C, Hôpital Necker Enfants malades, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, Paris, France.
Abstract
BACKGROUND: Systemic right ventricle (sRV) dysfunction in d-transposition of the great arteries following atrial switch (d-TGA) is associated with increased mortality. We aimed to characterize maladaptive sRV mechanisms in d-TGA patients, analyzing relation of echocardiographic parameters of sRV systolic function to objective measurements of exercise capacity. METHODS: Forty-seven adult patients with d-TGA and atrial switch (mean age 31.6±4.2years) underwent conventional echocardiography, bidimensional strain (2D-strain), cardiac magnetic resonance (CMR) imaging and cardiopulmonary exercise evaluation on the same day. Those with median peak oxygen uptake (VO2)>64.5% (n=23) constituted group A, those with VO2≤64.5% (n=24) constituted group B and 23 healthy age and gender matched subjects constituted the control group. RESULTS: In group A, global longitudinal peak systolic 2D-strain (GLS) of sRV was significantly reduced compared to GLS of normal RV and LV in the healthy control group (p<0.01), however peak longitudinal 2D strain was similar at basal and mid-segment of sRV free wall than normal LV. In group B, GLS was significantly reduced compared to group A (-10.9±2.9% vs -13.1±2.3%, p<0.05), mostly due to significant decrease of interventricular septum longitudinal strain. Other echocardiographic systolic parameters were not significantly different between groups A and B. Only sRV GLS showed significant correlation with functional capacity as measured by VO2 (r=0.42, p<0.01), while CMR RVEF did not. CONCLUSION: GLS of sRV predicts functional capacity and may be more sensitive than CMR RVEF in detecting early myocardial damage of sRV in patients with d-TGA and atrial switch.
BACKGROUND: Systemic right ventricle (sRV) dysfunction in d-transposition of the great arteries following atrial switch (d-TGA) is associated with increased mortality. We aimed to characterize maladaptive sRV mechanisms in d-TGApatients, analyzing relation of echocardiographic parameters of sRV systolic function to objective measurements of exercise capacity. METHODS: Forty-seven adult patients with d-TGA and atrial switch (mean age 31.6±4.2years) underwent conventional echocardiography, bidimensional strain (2D-strain), cardiac magnetic resonance (CMR) imaging and cardiopulmonary exercise evaluation on the same day. Those with median peak oxygen uptake (VO2)>64.5% (n=23) constituted group A, those with VO2≤64.5% (n=24) constituted group B and 23 healthy age and gender matched subjects constituted the control group. RESULTS: In group A, global longitudinal peak systolic 2D-strain (GLS) of sRV was significantly reduced compared to GLS of normal RV and LV in the healthy control group (p<0.01), however peak longitudinal 2D strain was similar at basal and mid-segment of sRV free wall than normal LV. In group B, GLS was significantly reduced compared to group A (-10.9±2.9% vs -13.1±2.3%, p<0.05), mostly due to significant decrease of interventricular septum longitudinal strain. Other echocardiographic systolic parameters were not significantly different between groups A and B. Only sRV GLS showed significant correlation with functional capacity as measured by VO2 (r=0.42, p<0.01), while CMR RVEF did not. CONCLUSION: GLS of sRV predicts functional capacity and may be more sensitive than CMR RVEF in detecting early myocardial damage of sRV in patients with d-TGA and atrial switch.
Authors: Karena Wu; Sunkyung Yu; Adam L Dorfman; Ray Lowery; Prachi P Agarwal; Maryam Ghadimi Mahani; Jimmy C Lu Journal: Pediatr Cardiol Date: 2019-07-25 Impact factor: 1.655
Authors: Michael Huntgeburth; Ingo Germund; Lianne M Geerdink; Narayanswami Sreeram; Floris E A Udink Ten Cate Journal: Cardiovasc Diagn Ther Date: 2019-10
Authors: Frederik Helsen; Piet Claus; Alexander Van De Bruaene; Guido Claessen; André La Gerche; Pieter De Meester; Mathias Claeys; Charlien Gabriels; Thibault Petit; Béatrice Santens; Els Troost; Jens-Uwe Voigt; Jan Bogaert; Werner Budts Journal: J Am Heart Assoc Date: 2018-10-16 Impact factor: 5.501