OpenLB
Open Library of Bioscience
Advanced Search
Congenital heart disease
Nov, 2019;14 (6): 1138-1148.

Echocardiography vs cardiac magnetic resonance imaging assessment of the systemic right ventricle for patients with d-transposition of the great arteries status post atrial switch.

Margaret M Samyn, Ke Yan, Conor Masterson, Benjamin H Goot, David Saudek, Julie Lavoie, Aaron Kinney, Mary Krolikowski, Kan Hor, Scott Cohen
Author Information
  1. Margaret M Samyn: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA. ORCID
  2. Ke Yan: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
  3. Conor Masterson: Department of Radiology, Aurora St. Luke's Medical Center, Milwaukee, WI, USA.
  4. Benjamin H Goot: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
  5. David Saudek: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
  6. Julie Lavoie: Herma Heart Institute, Children's Hospital of Wisconsin, Milwaukee, WI, USA.
  7. Aaron Kinney: Herma Heart Institute, Children's Hospital of Wisconsin, Milwaukee, WI, USA.
  8. Mary Krolikowski: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
  9. Kan Hor: Department of Clinical Pediatrics, Ohio State University College of Medicine, Columbus, OH, USA.
  10. Scott Cohen: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA. ORCID
PMID: 31816182 DOI: 10.1111/chd.12861

Abstract

OBJECTIVE: patients with Dextro-transposition of the great arteries status post atrial switch (dTGA s/p atrial switch) are "at-risk" for systemic right ventricular (RV) dysfunction. Due to complex RV geometry, echocardiography (Echo) does not allow accurate determination of ejection fraction (EF), but cardiac magnetic resonance imaging (CMR) allows quantitative right ventricular assessment. Measures of ventricular deformation may be precursors to global ventricular dysfunction. The primary aim of this study was to characterize imaging and clinical findings for adult patients with dTGA s/p atrial switch.
DESIGN: This was a retrospective cohort study of patients with dTGA s/p atrial switch operation (February 1966 to August 1988) with CMR performed at Children's Hospital of Wisconsin (from September 2005 to May 2015). Eligible patients had clinic visit, Echo, and exercise stress test within 1 year of CMR.
RESULTS: This study enrolled twenty-seven patients (16 males, 11 females) with dTGA s/p atrial switch (18 with Mustard operation and 9 with Senning operation; median age 30 years; 74% New York Heart Association class 1 and 26% class 2). Seventy-four percentage had normal RV systolic function (RV EF >45% by CMR). No correlation was observed between Echo strain data and clinical status (EF, exercise endurance, VO max, or New York Heart Association class). Cardiac magnetic resonance imaging RV global circumferential strain GCS and RV EF had moderate negative correlation (r = -0.65, P < .001). Global circumferential strain was significantly different for those with RV EF above and below 45%, while global peak longitudinal strain (GLS) was not. patients had reduced CMR myocardial strain values compared with healthy controls.
CONCLUSIONS: Reduced RV CMR GCS (for those with RV EF <45%) suggests that CMR evaluation may enhance early detection of detrimental changes in the systemic RV myocardium.

Keywords

cardiac magnetic resonance imaging (CMR) d-transposition of the great arteries (dTGA) myocardial strain

References

  1. Konstantinov IE, Alexi-Meskishvili VV, Williams WG, Freedom RM, Van Praagh R. Atrial switch operation: past, present, and future. Ann Thorac Surg. 2004;77:2250-2258.
  2. Gelatt M, Hamilton RM, McCrindle BW, et al. Arrhythmia and mortality after the Mustard procedure: a 30-year single-center experience. J Am Coll Cardiol. 1997;29:194-201.
  3. Oechslin EN, Harrison DA, Connelly MS, Webb GD, Siu SC. Mode of death in adults with congenital heart disease. Am J Cardiol. 2000;86:1111-1116.
  4. Diller G-P. Chasing a moving target: outcome and risk stratification in patients with transposition of the great arteries after atrial switch operation. Euro Heart J. 2014;35:1637-1641.
  5. Helbing WA, Hansen B, Ottenkamp J, et al. Long-term results of atrial correction for transposition of the great arteries. Comparison of Mustard and Senning operations. J Thorac Cardiovasc Surg. 1994;108:363-372.
  6. Tweddell JS. Atrial-level switch operation: lessons old and new. Circulation. 2015;132:619-620.
  7. Wheeler M, Grigg L, Zentner D. Can we predict sudden cardiac death in long-term survivors of atrial switch surgery for transposition of the great arteries? Congenit Heart Dis. 2014;9:326-332.
  8. Babu-Narayan SV, Goktekin O, Moon JC, et al. Late gadolinium enhancement cardiovascular magnetic resonance of the systemic right ventricle in adults with previous atrial redirection surgery for transposition of the great arteries. Circulation. 2005;111(16):2091-2098.
  9. Salehian O, Schwerzmann M, Merchant N, Webb GD, Siu SC, Therrien J. Assessment of systemic right ventricular function in patients with transposition of the great arteries using the myocardial performance index - comparison with cardiac magnetic resonance Imaging. Circulation. 2004;110:3229-3233.
  10. Tadic M. Multimodality evaluation of the right ventricle: an updated review. Clin Cardiol. 2015;38:770-776.
  11. Azam S, Desjardins CL, Schluchter M, et al. Comparison of velocity vector imaging echocardiography with magnetic resonance imaging in mouse models of cardiomyopathy. Circ Cardiovasc Imaging. 2012;5:776-781.
  12. Chelliah A, Dham N, Frank LH, Donofrio M, Krishnan A. Myocardial strain can be measured from first trimester fetal echocardiography using velocity vector imaging. Prenat Diagn. 2016;36:483-488.
  13. Colquitt JL, Pignatelli RH. Strain imaging: the emergence of speckle tracking echocardiography into clinical pediatric cardiology. Congenit Heart Dis. 2016;11:199-207.
  14. Eindhoven JA, Menting ME, van den Bosch AE, et al. Quantitative assessment of systolic right ventricular function using myocardial deformation in patients with a systemic right ventricle. Euro Heart J-Cardiovasc Imaging. 2014;16:380-388.
  15. Kalogeropoulos AP, Deka A, Border W, et al. Right ventricular function with standard and speckle-tracking echocardiography and clinical events in adults with D-transposition of the great arteries post atrial switch. J Am Soc Echocardiogr. 2012;25:304-312.
  16. Park JH, Kusunose K, Kwon DH, et al. Relationship between right ventricular longitudinal strain, invasive hemodynamics, and functional assessment in pulmonary arterial hypertension. Korean Circ J. 2015;45:398-407.
  17. Fratz S, Chung T, Greil GF, et al. Guidelines and protocols for cardiovascular magnetic resonance in children and adults with congenital heart disease: SCMR expert consensus group on congenital heart disease. J Cardiovasc Magn Reson. 2013;15:51.
  18. Kutty S, Deatsman SL, Nugent ML, Russell D, Frommelt PC. Assessment of regional right ventricular velocities, strain, and displacement in normal children using velocity vector imaging. Echocardiography. 2008;25:294-307.
  19. Lipczynska M, Szymanski P, Kumor M, Klisiewicz A, Mazurkiewicz L, Hoffman P. Global longitudinal strain may identify preserved systolic function of the systemic right ventricle. Can J Cardiol. 2015;31:760-766.
  20. Takeuchi D, Nakanishi T, Tomimatsu H, Nakazawa M. Evaluation of right ventricular performance long after the atrial switch operation for transposition of the great arteries using the Doppler Tei index. Pediatr Cardiol. 2006;27:78-83.
  21. Tei C, Nishimura RA, Seward JB, Tajik AJ. Noninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements. J Am Soc Echocardiogr. 1997;10:169-178.
  22. Yasuoka K, Harada K, Toyono M, Tamura M, Yamamoto F. Tei index determined by tissue Doppler imaging in patients with pulmonary regurgitation after repair of tetralogy of Fallot. Pediatr Cardiol. 2004;25:131-136.
  23. Lin LI. A concordance correlation coefficient to evaluate reproducibility. Biometrics. 1989;45:255-268.
  24. Houck CA, Teuwen CP, Bogers AJ, de Groot NM. Atrial tachyarrhythmias after atrial switch operation for transposition of the great arteries: treating old surgery with new catheters. Heart Rhythm. 2016;13:1731-1738.
  25. Dos L, Teruel L, Ferreira IJ, et al. Late outcome of Senning and Mustard procedures for correction of transposition of the great arteries. Heart. 2005;91:652-656.
  26. Diller GP, Radojevic J, Kempny A, et al. 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. 2012;163:859-866.
  27. Petersen SE, Hudsmith LE, Robson MD, et al. Sex-specific characteristics of cardiac function, geometry, and mass in young adult elite athletes. J Magn Reson Imaging. 2002;24:297-303.
  28. Grothoff M, Hoffmann J, Abdul-Khaliq H, et al. Right ventricular hypertrophy after atrial switch operation: normal adaptation process or risk factor? A cardiac magnetic resonance study. Clin Res Cardiol. 2012;101:963-971.
  29. Jimenez-Juan L, Joshi SB, Wintersperger BJ, et al. Assessment of right ventricular volumes and function using cardiovascular magnetic resonance cine imaging after atrial redirection surgery for complete transposition of the great arteries. Int J Cardiovasc Imaging. 2013;29:335-342.
  30. Winter MM, Bernink FJ, Groenink M, et al. Evaluating the systemic right ventricle by CMR: the importance of consistent and reproducible delineation of the cavity. J Cardiovasc Magn Reson. 2008;10:40.
  31. Keller EJ, Fang S, Lin K, et al. The consistency of myocardial strain derived from heart deformation analysis. Int J Cardiovasc Imaging. 2017;33:1169-1177.
  32. Thattaliyath BD, Forsha DE, Stewart C, Barker PC, Campbell MJ. Evaluation of right ventricular myocardial mechanics using velocity vector imaging of cardiac MRI cine images in transposition of the great arteries following atrial and arterial switch operations. Congenit Heart Dis. 2015;10:371-379.
  33. Carlsson M, Ugander M, Heiberg E, Arheden H. The quantitative relationship between longitudinal and radial function in left, right, and total heart pumping in humans. Am J Physiol Heart Circ Physiol. 2007;293:H636-H644.
  34. de Siqueira ME, Pozo E, Fernandes VR, et al. Characterization and clinical significance of right ventricular mechanics in pulmonary hypertension evaluated with cardiovascular magnetic resonance feature tracking. J Cardiovasc Magn Reson. 2016;18(1):39.
  35. Muraru D, Onciul S, Peluso D, et al. Sex- and method-specific reference values for right ventricular strain by 2-dimensional speckle-tracking echocardiography. Circ Cardiovasc Imaging. 2016;9(2):e003866.
  36. Menting ME, McGhie JS, Koopman LP, et al. Normal myocardial strain values using 2D speckle tracking echocardiography in healthy adults aged 20 to 72 years. Echocardiography. 2016;33(11):1665-1675.
  37. Ladouceur M, Redheuil A, Soulat G, et al. Longitudinal strain of systemic right ventricle correlates with exercise capacity in adult with transposition of the great arteries after atrial switch. Int J Cardiol. 2016;217:28-34.
  38. Fratz S, Schuhbaeck A, Buchner C, et al. Comparison of accuracy of axial slices versus short-axis slices for measuring ventricular volumes by cardiac magnetic resonance in patients with corrected tetralogy of fallot. Am J Cardiol. 2009;103:1764-1769.

Grants

  1. T32 (PI-Dr David Harder)/NIH HHS
  2. 2T35 (HL072483-32) (PI: David Harder)/National Heart, Lung Blood Institute Training

MeSH Term

Adult
Arterial Switch Operation
Cross-Sectional Studies
Early Diagnosis
Echocardiography, Doppler, Color
Female
Humans
Magnetic Resonance Imaging, Cine
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Stroke Volume
Transposition of Great Vessels
Treatment Outcome
Ventricular Function, Right
Young Adult
Comparative Study Journal Article
Article has an altmetric score of 6

Word Cloud

Created with Highcharts 10.0.0RVCMRatrialswitchEFstraindTGAimagingpatientss/pventricularmagneticresonancegreatarteriesstatussystemicrightEchocardiacglobalstudyoperationclassPatientspostdysfunctionassessmentmayclinicalexercise1NewYorkHeartAssociationcorrelationcircumferentialGCSmyocardiald-transpositionOBJECTIVE:Dextro-transposition"at-risk"DuecomplexgeometryechocardiographyallowaccuratedeterminationejectionfractionallowsquantitativeMeasuresdeformationprecursorsprimaryaimcharacterizefindingsadultDESIGN:retrospectivecohortFebruary1966August1988performedChildren'sHospitalWisconsinSeptember2005May2015EligibleclinicvisitstresstestwithinyearRESULTS:enrolledtwenty-seven16males11females18Mustard9Senningmedianage30 years74%26%2Seventy-fourpercentagenormalsystolicfunction>45%observeddataenduranceVOmaxCardiacmoderatenegativer = -065P <001Globalsignificantlydifferent45%peaklongitudinalGLSreducedvaluescomparedhealthycontrolsCONCLUSIONS:Reduced<45%suggestsevaluationenhanceearlydetectiondetrimentalchangesmyocardiumEchocardiographyvsventricle

Similar Articles

Cited By (3)