Systemic right ventricular longitudinal strain is reduced in adults with transposition of the great arteries, relates to subpulmonary ventricular function, and predicts adverse clinical outcome.
Am Heart J
; 163(5): 859-66, 2012 May.
Article
em En
| MEDLINE
| ID: mdl-22607865
ABSTRACT
BACKGROUND:
Transposition of the great arteries (TGA) after atrial switch operation and congenitally corrected TGA (ccTGA) are commonly associated with impaired systemic right ventricular (RV) function and impaired prognosis. We aimed to investigate the value of indices of myocardial deformation on speckle-tracking echocardiography for quantifying ventricular function and their potential role in assessing ventricular-ventricular interaction and outcome in patients with a systemic RV. METHODS ANDRESULTS:
A total of 129 patients (87 with TGA and atrial switch and 42 with ccTGA, 71 men, age 35 ± 12 years) were investigated, and biventricular myocardial deformation was compared with findings in healthy subjects (n = 38, age 36 ± 10 years). Systemic ventricular longitudinal 2-dimensional (2D) peak systolic strain (RV 2D-LS) was significantly reduced compared with controls (-12.9 ± 3.6 and -15.4 ± 5.1 vs -21.0 ± 5.5 in TGAs, ccTGAs, and controls, P < .0001). Systemic and pulmonary 2D-LS were correlated in patients with TGA (r = 0.46, P < .0001) and ccTGA (r = 0.64, P < .0001), suggesting interventricular interaction, and this was confirmed when ejection fraction on magnetic resonance imaging was assessed (r = 0.53, P < .0001). More importantly, systemic 2D-LS (hazard ratio 1.31, P = .01) was related to adverse clinical outcome (symptomatic progression to New York Heart Association class ≥3, clinically relevant cardiac arrhythmia, or death) in patients with TGA and atrial switch independently of ejection fraction on cardiac magnetic resonance imaging, history of clinically relevant arrhythmia, or functional class.CONCLUSIONS:
Global longitudinal systolic strain is significantly reduced in patients with a systemic RV, is related to subpulmonary ventricular function, and predicts adverse clinical outcome in adults with atrial switch TGA.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Volume Sistólico
/
Transposição dos Grandes Vasos
/
Disfunção Ventricular Direita
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
Am Heart J
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Reino Unido