Echocardiogram Versus Cardiac Magnetic Resonance Imaging for Assessing Systolic Function of Subaortic Right Ventricle in Adults With Complete Transposition of Great Arteries and Previous Atrial Switch Operation

Khattab, Kerstin; Schmidheiny, Pascal; Wustmann, Kerstin; Wahl, Andreas; Seiler, Christian; Schwerzmann, Markus

doi:10.1016/j.amjcard.2012.11.044

Cited by 44 publications

(27 citation statements)

References 23 publications

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“…Although contemporary guidelines caution against pregnancy in women with a systemic RV and moderate RV systolic dysfunction [8], a more precise definition has been lacking as assessment of systemic RV function by echocardiography has been mostly qualitative rather than quantitative. While echocardiographic assessment of systemic RV function can have important limitations [14], the CMR assessment of the RV has been shown to be accurate and reproducible [18], [19], [20] and is therefore accepted as the imaging reference standard for measurements within the right heart [10], [11]. This is the first study to define the CMR characteristics of women after atrial redirection surgery undergoing pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…For the purposes of this study, all images were analyzed by a single experienced observer (LJJ) using a dedicated workstation and commercial software (Argus, Siemens Healthcare, Erlangen, Germany) in a core laboratory at the University Heath Network, Toronto. Moderate RV systolic dysfunction was defined as RVEF < 35% as previously established in non-pregnant adults with atrial redirection surgery for complete TGA [3], [14], [15], [16].…”

Section: Methodsmentioning

confidence: 99%

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Cardiac magnetic resonance imaging characteristics and pregnancy outcomes in women with Mustard palliation for complete transposition of the great arteries

Jiménez-Juan

Valente

Silversides

et al. 2016

IJC Heart & Vasculature

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BackgroundWomen with transposition of the great arteries (TGA) following atrial redirection surgery are at risk of pregnancy-associated arrhythmia and heart failure. The cardiovascular magnetic resonance imaging (CMR) characteristics of these women and the relationship of CMR findings to pregnancy outcomes have not been described.MethodsWe included 17 women with atrial redirection surgery and CMR within 2 years of delivery.ResultsAll women were asymptomatic at baseline (New York Heart Association Class 1). CMR studies were completed pre-pregnancy in 3, antepartum/peripartum in 2, and postpartum in 12 women. Three women (3/17, 18%) experienced major cardiovascular events related to pregnancy: cardiac arrest (n = 1) and symptomatic atrial arrhythmia (n = 2). Median gestational age at delivery was 38 weeks (24–39 weeks) and birth weight was 2770 g (2195–3720 g). Complications were seen in 3 offspring (3/17, 18%): death (n = 1) and prematurity (n = 2). CMR characteristics included median right ventricular end diastolic volume 119 mL/m2 (range 85–214 mL/m2) and median right ventricular ejection fraction (RVEF) 37% (range 30–51%). All women with cardiovascular complications had an RVEF < 35% (range 32–34%). The association between RVEF < 35% and cardiovascular complications trended towards statistical significance (p = 0.05). No statistically significant differences in CMR measurements were found between those with and without neonatal complications.ConclusionsWhile the majority of women in this cohort had successful outcomes following pregnancy, important cardiovascular complications were seen in a significant minority, all of whom had an RVEF < 35%. The preliminary findings of our study provide impetus for a larger prospective study to evaluate the prognostic role of CMR in pregnant women with atrial redirection surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Cardiac magnetic resonance imaging characteristics and pregnancy outcomes in women with Mustard palliation for complete transposition of the great arteries

Jiménez-Juan

Valente

Silversides

et al. 2016

IJC Heart & Vasculature

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“…Among the standard echocardiographic indices of the systolic RV function, only fractional area change differed between the subgroups, and the nonparametric indices of the systolic RV function were similar in the overweight/obese and normal weight patients. However, these parameters are usually applied to evaluate the subpulmonary RV, and some investigators suggested that they are not suitable for systemic RV assessment [14,15].…”

Section: Discussionmentioning

confidence: 99%

Assessment of systemic right ventricular function in adult overweight and obese patients with congenitally corrected transposition of the great arteries

Kowalik¹,

Klisiewicz²,

Biernacka³

et al. 2017

Kardiol Pol

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A b s t r a c t Background:In congenitally corrected transposition of the great arteries the right ventricle (RV) supports systemic circulation, and patients are prone to develop heart failure over time. Chronic volume overload secondary to obesity may contribute to premature dysfunction of the systemic RV. Aim:The aim of our study was to assess the systemic RV function in overweight/obese adult patients with congenitally corrected transposition of the great arteries. Methods:Transthoracic echocardiographic studies and laboratory testing (N-terminal pro-B-type natriuretic peptide [NT-proBNP] assessment) were performed in patients with congenitally corrected transposition, who were scheduled for a routine examination, and the body mass index was calculated for each patient. Results:We studied 56 adults (31 men; mean age 33.9 years); 22 of whom were overweight (body mass index [BMI] of 25-29.9 kg/m 2 ) or obese (BMI of 30 kg/m 2 or more), and 34 of whom were normal weight (BMI below 25 kg/m 2 ). Age, gender, heart rate, and blood pressure were similar in both groups. The mean NT-proBNP levels were not significantly different. On echocardiography, the overweight/obese patients had a decreased systemic RV fractional area change (0.38) compared to normal weight patients (0.43); p = 0.02. Moreover, a significant reduction in the global longitudinal strain in the overweight/obese group was observed (-15.3% vs. -18.3%; p = 0.01).Conclusions: Overweight/obesity in adult patients with congenitally corrected transposition of the great arteries is associated with impaired systemic RV function.

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“…A reduction of fractional area change <33% identified an RVEF < 50% with 77% sensitivity and 58% specificity. 78 Isovolumic acceleration of the RV free wall is another measure that has been used for assessment of RV function after the AtrSO. 79 Three-dimensional echocardiography is a technique that is potentially very useful for the assessment of RV volumes and EF in this population.…”

Section: Assessment Of Ventricular Function After the Aso And Atrsomentioning

confidence: 99%

Multimodality Imaging Guidelines of Patients with Transposition of the Great Arteries: A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography

Cohen

Eidem

Cetta

et al. 2016

Journal of the American Society of Echocardiography

115

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Echocardiogram Versus Cardiac Magnetic Resonance Imaging for Assessing Systolic Function of Subaortic Right Ventricle in Adults With Complete Transposition of Great Arteries and Previous Atrial Switch Operation

Cited by 44 publications

References 23 publications

Cardiac magnetic resonance imaging characteristics and pregnancy outcomes in women with Mustard palliation for complete transposition of the great arteries

Cardiac magnetic resonance imaging characteristics and pregnancy outcomes in women with Mustard palliation for complete transposition of the great arteries

Assessment of systemic right ventricular function in adult overweight and obese patients with congenitally corrected transposition of the great arteries

Multimodality Imaging Guidelines of Patients with Transposition of the Great Arteries: A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography

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