Longitudinal strain of systemic right ventricle correlates with exercise capacity in adult with transposition of the great arteries after atrial switch

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:217

Article

Ladouceur, Magalie^1,2,3  Redheuil, Alban⁴  Soulat, Gilles^1,4  Delclaux, Christophe⁵  Azizi, Michel⁶  Patel, Mehul⁷  Chatellier, Gilles⁸  Legendre, Antoine^2,3  Iserin, Laurence^2,3  Boudjemline, Younes^2,3  Bonnet, Damien²  Mousseaux, Elie^1,4 

[1] Univ Paris 05, Paris Cardiovasc Res Ctr, INSERM U970, Paris, France

[2] Univ Paris 05, Dept Paediat Cardiol, Ctr Reference Malformat Cardiaques Congenitales C, Hop Necker Enfants Malad,AP HP,M3C, Paris, France

[3] Univ Paris 05, Adult Congenital Heart Dis Unit, Dept Cardiol, Hop Europeen Georges Pompidou,AP HP, Paris, France

[4] Univ Paris 05, Dept Cardiovasc Radiol, Hop Europeen Georges Pompidou, AP HP, Paris, France

[5] Univ Paris 05, Serv Physiol Clin Dyspnee, Hop Europeen Georges Pompidou, AP HP, Paris, France

[6] Univ Paris 05, Hop Europeen Georges Pompidou, AP HP, Ctr Invest Clin, F-75015 Paris, France

[7] Baylor Coll Med, Houston, TX 77030 USA

[8] Univ Paris 05, Clin Res Unit, Hop Europeen Georges Pompidou, AP HP, Paris, France

关键词: Transposition of the great arteries;    Systemic right ventricle;    Magnetic resonance imaging;    Strain;   

DOI  :  10.1016/j.ijcard.2016.04.166

来源: Elsevier

【 摘 要 】

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 +/- 4.2 years) 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) N64.5% (n = 23) constituted group A, thosewith 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. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

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