The systemic right ventricle in congenitally corrected transposition of the great arteries is different from the right ventricle in dextro-transposition after atrial switch: a cardiac magnetic resonance study.

Abstract

BACKGROUND:

Patients with a congenitally corrected transposition of the great arteries show an increasing incidence of cardiac failure with age. In other systemic right ventricles, such as in dextro-transposition after atrial switch, excessive hypertrophy is a potential risk factor for impaired systolic function. In this trial, we sought to compare systemic function and volumes between patients with congenitally corrected transposition and those with dextro-transposition after atrial switch by using cardiac magnetic resonance imaging.

METHODS AND RESULTS:

A total of 19 patients (nine male) with congenitally corrected transposition and 31 patients (21 male) with dextro-transposition after atrial switch were studied using a 1.5-Tesla scanner. Cine steady-state free-precession sequences in standard orientations were acquired for volumetric and functional imaging. Patient parameters were compared with those of a group of 25 healthy volunteers. Although patients with congenitally corrected transposition were older, they presented with higher right ventricular ejection fractions (p = 0.04) compared with patients with dextro-transposition. Patients with congenitally corrected transposition showed a weak negative correlation between age at examination and systemic ejection fraction (r = −0.18, p = 0.04) but no correlation between right ventricular myocardial mass index and ejection fraction. There was no significant difference in the right ventricular end-diastolic volumes between both patient groups.

CONCLUSION:

Although patients with congenitally corrected transposition had a longer pressure load of the systemic right ventricle, ventricular function was better compared with that in patients with dextro-transposition after atrial switch. The results suggest that the systemic ventricles might have partly different physiologies. One difference could be the post-operative situation after atrial switch, which results in impaired atrial contribution to ventricular filling.

• Authors: Matthias Grothoff, Antje Fleischer, Hashim Abdul-Khaliq, Janine Hoffmann, Lukas Lehmkuhl, Christian Luecke, Matthias Gutberlet
• Journal: Cardiology in the young (Cardiol Young) Vol. 23 Issue 2 Pg. 239-47 (Apr 2013) ISSN: 1467-1107 [Electronic] England
• PMID: 22694856 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Case-Control Studies
• Congenitally Corrected Transposition of the Great Arteries
• Female
• Heart Atria (surgery)
• Heart Failure (etiology, pathology, physiopathology)
• Heart Ventricles (pathology, physiopathology)
• Humans
• Hypertrophy, Right Ventricular (etiology, pathology, physiopathology)
• Magnetic Resonance Imaging, Cine
• Male
• Middle Aged
• Transposition of Great Vessels (complications, pathology, physiopathology, surgery)
• Ventricular Dysfunction, Right (etiology, pathology, physiopathology)
• Young Adult