BACKGROUND: The purpose of this study was to assess the role of echocardiography for a comprehensive assessment of cardiac remodeling, and the relationship between indices of cardiac remodeling and cardiovascular events (defined as the composite end point of heart failure hospitalization, heart transplant, or cardiovascular death) in adults with congenitally corrected transposition of great arteries (cc-TGA). METHODS: This is a retrospective study of adults with cc-TGA who underwent echocardiogram (2003-2020). Offline image analysis was performed in all patients. Chamber (atrial and ventricular) function and size were assessed by strain imaging and 2-dimensional echocardiography. RESULTS: Of 233 patients with cc-TGA (40±15 years), 123 (55%) had at least one cardiac procedure before baseline echocardiogram. Of 233 patients, 76% and 61% had left atrial dysfunction and systemic right ventricular dysfunction, respectively; while 43% and 11% had right atrial dysfunction and left ventricular dysfunction, respectively. During a median follow-up of 8.9 years, 114 (49%) underwent additional cardiac procedures, and 66 (28%) had cardiovascular events. Left atrial reservoir strain, right ventricular global longitudinal strain, right atrial reservoir strain, left ventricular systolic pressure, and left ventricular global longitudinal strain were independently associated with cardiovascular events. CONCLUSIONS: In addition to the clinical importance of right ventricular systolic dysfunction in cc-TGA that is already well described, the current study demonstrated, for the first time, that biatrial dysfunction was common and was associated with clinical outcomes. Since there are currently no effective therapies for atrial and ventricular dysfunction in patients with cc-TGA, there is a need for research to identify novel strategies to prevent atrial and ventricular dysfunction in this population.
BACKGROUND: The purpose of this study was to assess the role of echocardiography for a comprehensive assessment of cardiac remodeling, and the relationship between indices of cardiac remodeling and cardiovascular events (defined as the composite end point of heart failure hospitalization, heart transplant, or cardiovascular death) in adults with congenitally corrected transposition of great arteries (cc-TGA). METHODS: This is a retrospective study of adults with cc-TGA who underwent echocardiogram (2003-2020). Offline image analysis was performed in all patients. Chamber (atrial and ventricular) function and size were assessed by strain imaging and 2-dimensional echocardiography. RESULTS: Of 233 patients with cc-TGA (40±15 years), 123 (55%) had at least one cardiac procedure before baseline echocardiogram. Of 233 patients, 76% and 61% had left atrial dysfunction and systemic right ventricular dysfunction, respectively; while 43% and 11% had right atrial dysfunction and left ventricular dysfunction, respectively. During a median follow-up of 8.9 years, 114 (49%) underwent additional cardiac procedures, and 66 (28%) had cardiovascular events. Left atrial reservoir strain, right ventricular global longitudinal strain, right atrial reservoir strain, left ventricular systolic pressure, and left ventricular global longitudinal strain were independently associated with cardiovascular events. CONCLUSIONS: In addition to the clinical importance of right ventricular systolic dysfunction in cc-TGA that is already well described, the current study demonstrated, for the first time, that biatrial dysfunction was common and was associated with clinical outcomes. Since there are currently no effective therapies for atrial and ventricular dysfunction in patients with cc-TGA, there is a need for research to identify novel strategies to prevent atrial and ventricular dysfunction in this population.
Authors: Gerhard-Paul Diller; Jelena Radojevic; Aleksander Kempny; Rafael Alonso-Gonzalez; Liodakis Emmanouil; Stefan Orwat; Lorna Swan; Anselm Uebing; Wei Li; Konstantinos Dimopoulos; Michael A Gatzoulis; Helmut Baumgartner Journal: Am Heart J Date: 2012-05 Impact factor: 4.749
Authors: T P Graham; Y D Bernard; B G Mellen; D Celermajer; H Baumgartner; F Cetta; H M Connolly; W R Davidson; M Dellborg; E Foster; W M Gersony; I H Gessner; R A Hurwitz; H Kaemmerer; J D Kugler; D J Murphy; J A Noonan; C Morris; J K Perloff; S P Sanders; J L Sutherland Journal: J Am Coll Cardiol Date: 2000-07 Impact factor: 24.094
Authors: Philippe Meyer; Gerasimos S Filippatos; Mustafa I Ahmed; Ami E Iskandrian; Vera Bittner; Gilbert J Perry; Michel White; Inmaculada B Aban; Marjan Mujib; Louis J Dell'Italia; Ali Ahmed Journal: Circulation Date: 2010-01-04 Impact factor: 29.690
Authors: Ying Ye; Ravi Desai; Lina M Vargas Abello; Jeevanantham Rajeswaran; Allan L Klein; Eugene H Blackstone; Gösta B Pettersson Journal: J Thorac Cardiovasc Surg Date: 2014-03-01 Impact factor: 5.209
Authors: Alexander C Egbe; William R Miranda; Joseph A Dearani; Heidi M Connolly Journal: Circ Cardiovasc Imaging Date: 2021-02-15 Impact factor: 7.792