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- Open Access
Comparison of systemic right ventricular function in transposition of the great arteries after atrial switch and congenitally corrected transposition of the great arteries
© Morcos et al. 2016
- Published: 27 January 2016
- Cardiac Magnetic Resonance
- Right Ventricle
- Great Artery
- Tricuspid Annular Plane Systolic Excursion
- Longitudinal Contraction
In patients with transposition of the great arteries corrected by interatrial baffle (TGA) and those with congenitally corrected transposition of the great arteries (ccTGA) the right ventricle (RV) is subjected to systemic pressures and fails prematurely. We sought to further characterize the geometric, global and regional functional differences between these two groups.
Using cardiac magnetic resonance imaging (MRI) the RV was reconstructed from manually traced borders of the ventricles, valves, and other anatomic landmarks of 25 patients with TGA, 17 patients with ccTGA, and 9 normal subjects. Global function was assessed by calculating RV ejection fraction (RVEF) as well as tricuspid annular plane systolic excursion (TAPSE). Regional wall motion was assessed in ten anatomic territories of the RV using the centersurface method.
The RV in TGA and ccTGA was more dilated, rounder, and had reduced global and regional function when compared to the normal RV. RVEF correlated better with transverse than longitudinal contraction. When the subgroups were compared, TGA patients had lower RVEF than ccTGA (29.7 ± 6.5% vs. 34.7 ± 7.4 %, p = 0.02), lower normalized TAPSE (0.097 ± 0.035 vs. 0.177 ± 0.044, p <0.01), and weaker basal segment contraction (image 1 and 2). However RV shape was similar in the two groups, and there was only a tendency towards a more dilated TGA RV (end diastolic volume index 145 ± 35 vs. 132 ± 41 mL/m2 in ccTGA, p= 0.09).
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