Impaired atrioventricular transport in patients with transposition of the great arteries palliated by atrial switch and preserved systolic right ventricular function : A magnetic resonance imaging study
© 2017 Wiley Periodicals, Inc..
OBJECTIVES: We aimed (1) determine if systemic right ventricle filling parameters influence systemic right ventricle stroke volume in adult patients with D-transposition of the great arteries (D-TGA) palliated by atrial switch, using cardiac magnetic resonance imaging and echocardiography, and (2) to study relationship of these diastolic parameters with exercise performance and BNP, in patients with preserved systolic systemic right ventricle function.
DESIGN: Single-center, cross-sectional, prospective study.
SETTING: In patients with D-TGA palliated by atrial switch, diastolic dysfunction of the systemic right ventricle may precede systolic dysfunction.
METHODS: Forty-five patients with D-TGA and atrial switch and 45 age and sex-matched healthy subjects underwent cardiac magnetic resonance imaging and echocardiography. Filling flow-rates measured by phase-contrast cardiac magnetic resonance imaging were analyzed using customized software to estimate diastolic parameters and compared with exercise performance.
RESULTS: In D-TGA, early filling of systemic right ventricle was impaired with a lower peak filling rate normalized by filling volume (Ef/FV measured by cardiac magnetic resonance imaging) and a higher early filling peak velocity normalized by early peak myocardial velocity (EUS /Ea measured by echocardiography) compared with controls (P ≤ .04). Stroke volume of systemic right ventricle showed a direct and significant association with pulmonary venous pathway size (respectively r = 0.50, P < .01). Systemic right atrial area and systemic right ventricle mass/volume index measured by cardiac magnetic resonance imaging, as well as Ef/FV were significantly correlated with exercise performances and BNP (P < .01). All correlations were independent of age, gender, body mass index and blood pressure.
CONCLUSIONS: Systemic right ventricle pre-load and stroke volume depend mainly on intraatrial pathway function. Moreover, systemic right ventricle remodeling and right atrial dysfunction impair systemic right ventricle filling, leading to BNP increase and exercise limitation. Cardiac magnetic resonance imaging should assess systemic right ventricle filling abnormalities in D-TGA patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
Congenital heart disease - 12(2017), 4 vom: 07. Juli, Seite 458-466 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ladouceur, Magalie [VerfasserIn] |
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| Links: |
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| Themen: |
Atrial function |
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| Anmerkungen: |
Date Completed 02.11.2017 Date Revised 02.11.2017 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/chd.12472 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM271932910 |
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| 100 | 1 | |a Ladouceur, Magalie |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impaired atrioventricular transport in patients with transposition of the great arteries palliated by atrial switch and preserved systolic right ventricular function |b A magnetic resonance imaging study |
| 264 | 1 | |c 2017 | |
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| 500 | |a Date Revised 02.11.2017 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2017 Wiley Periodicals, Inc. | ||
| 520 | |a OBJECTIVES: We aimed (1) determine if systemic right ventricle filling parameters influence systemic right ventricle stroke volume in adult patients with D-transposition of the great arteries (D-TGA) palliated by atrial switch, using cardiac magnetic resonance imaging and echocardiography, and (2) to study relationship of these diastolic parameters with exercise performance and BNP, in patients with preserved systolic systemic right ventricle function | ||
| 520 | |a DESIGN: Single-center, cross-sectional, prospective study | ||
| 520 | |a SETTING: In patients with D-TGA palliated by atrial switch, diastolic dysfunction of the systemic right ventricle may precede systolic dysfunction | ||
| 520 | |a METHODS: Forty-five patients with D-TGA and atrial switch and 45 age and sex-matched healthy subjects underwent cardiac magnetic resonance imaging and echocardiography. Filling flow-rates measured by phase-contrast cardiac magnetic resonance imaging were analyzed using customized software to estimate diastolic parameters and compared with exercise performance | ||
| 520 | |a RESULTS: In D-TGA, early filling of systemic right ventricle was impaired with a lower peak filling rate normalized by filling volume (Ef/FV measured by cardiac magnetic resonance imaging) and a higher early filling peak velocity normalized by early peak myocardial velocity (EUS /Ea measured by echocardiography) compared with controls (P ≤ .04). Stroke volume of systemic right ventricle showed a direct and significant association with pulmonary venous pathway size (respectively r = 0.50, P < .01). Systemic right atrial area and systemic right ventricle mass/volume index measured by cardiac magnetic resonance imaging, as well as Ef/FV were significantly correlated with exercise performances and BNP (P < .01). All correlations were independent of age, gender, body mass index and blood pressure | ||
| 520 | |a CONCLUSIONS: Systemic right ventricle pre-load and stroke volume depend mainly on intraatrial pathway function. Moreover, systemic right ventricle remodeling and right atrial dysfunction impair systemic right ventricle filling, leading to BNP increase and exercise limitation. Cardiac magnetic resonance imaging should assess systemic right ventricle filling abnormalities in D-TGA patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a atrial function | |
| 650 | 4 | |a cardiac magnetic resonance imaging | |
| 650 | 4 | |a diastolic function | |
| 650 | 4 | |a filling flow | |
| 650 | 4 | |a transposition of the great arteries | |
| 700 | 1 | |a Kachenoura, Nadjia |e verfasserin |4 aut | |
| 700 | 1 | |a Soulat, Gilles |e verfasserin |4 aut | |
| 700 | 1 | |a Bollache, Emilie |e verfasserin |4 aut | |
| 700 | 1 | |a Redheuil, Alban |e verfasserin |4 aut | |
| 700 | 1 | |a Azizi, Michel |e verfasserin |4 aut | |
| 700 | 1 | |a Delclaux, Christophe |e verfasserin |4 aut | |
| 700 | 1 | |a Chatellier, Gilles |e verfasserin |4 aut | |
| 700 | 1 | |a Boutouyrie, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Iserin, Laurence |e verfasserin |4 aut | |
| 700 | 1 | |a Bonnet, Damien |e verfasserin |4 aut | |
| 700 | 1 | |a Mousseaux, Elie |e verfasserin |4 aut | |
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