Clinical InvestigationValvular and Congenital Heart DiseaseSystemic right ventricular longitudinal strain is reduced in adults with transposition of the great arteries, relates to subpulmonary ventricular function, and predicts adverse clinical outcome
Section snippets
Patients and methods
We identified patients with a systemic RV who attended the Adult Congenital Heart Disease Programme, Royal Brompton Hospital, London, and the Adult Congenital and Valvular Heart Disease Center at the University of Münster, Germany, and had undergone a transthoracic echocardiogram between May 2005 and April 2010. Patients in whom adequate echocardiographic sequences were not recorded or digitally stored were excluded. For those patients who had ≥1 echocardiographic investigation during this
Results
Overall, 129 consecutive patients with a systemic RV (87 with TGA and atrial switch and 42 with ccTGA, 71 men, age 35 ± 12 years) in whom adequate echocardiographic recordings were available were included. Patients' demographics are presented in Table I.
Discussion
The present study demonstrates that biventricular 2D-LS is reduced in adult patients with a systemic RV and relates to adverse clinical outcome in this setting. Systemic and subpulmonary myocardial functions appear interrelated in patients with TGA, suggesting adverse ventriculo-ventricular interaction, and the relationship between systemic and subpulmonary ventricular functions was found to be most pronounced in patients with ccTGA and pulmonary stenosis.
Previous studies have demonstrated
Conclusions
Systemic 2D-LS is significantly reduced in patients with a systemic RV and relates to worse clinical outcome in the setting of atrial switch TGA. Systemic and subpulmonary myocardial functions appear interrelated, and this may be because of adverse ventriculo-ventricular interaction. Right ventricular 2D-LS is readily available from routine echocardiography using modern commercial analysis software, represents an objective measure of systemic RV function, and should assist clinicians in
Disclosures
Conflict of interest: None of the authors has any conflict of interest.
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2021, International Journal of CardiologyCitation Excerpt :Through the mechanisms of interventricular interaction, LV impairment may be influenced by the SRV dysfunction and dyssynchrony [20]. Thus, 2D speckle tracking longitudinal strain of the SRV and pulmonary LV significantly correlated in patients with both TGA and ccTGA (R = 0.46 and 0.64, respectively, p < 0.0001) [6]. We found a positive correlation of CMR-derived LV and SRV EF, which is in agreement with previous CMR studies [6,21,22].
- c
First and second authors contributed equally to the study.