Right Ventricular Performance and Mass by Use of Cine MRI Late After Atrial Repair of Transposition of the Great Arteries

Lorenz, Christine H.; Walker, Eloisa S.; Graham, T.P.; Powers, Thomas A.

doi:10.1161/01.cir.92.9.233

Cited by 115 publications

(61 citation statements)

References 22 publications

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“…8,11 Volumes were measured by manually tracing the area of the endocardial and epicardial surfaces, respectively. The moderator band or other large trabeculae were included in the myocardial volume area.…”

Section: Assessment Of Rv and LV Volumes And Myocardial Massmentioning

confidence: 99%

“…8 Increased ventricular mass was defined as a measure of ventricular hypertrophy. Myocardial mass was determined separately for the interventricular septum, RV, and LV free wall.…”

Section: Myocardial Hypertrophy and Rv Fiber Stressmentioning

confidence: 99%

“…8 -10 MRI is widely considered the "gold standard" to assess ventricular pump function but is limited in its ability to determine cardiovascular pressures required for assessment of more loadindependent parameters of ventricular function. 8,9,11 However, assessment of load-independent parameters, including myocardial contractility, is important to better predict the clinical course of patients with a chronically pressureoverloaded RV and might help to guide therapy and to optimize the timing of catheter-based intervention or surgical procedures.…”

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confidence: 99%

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Magnetic Resonance Imaging Analysis of Right Ventricular Pressure-Volume Loops

Küehne

Yilmaz²,

Steendijk³

et al. 2004

Circulation

330

125

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Background-The aims of this study were to validate MRI-derived right ventricular (RV) pressure-volume loops for assessment of RV myocardial contractility and then to apply this technique in patients with chronic RV pressure overload for assessment of myocardial contractility, ventricular pump function, and VA coupling. Methods and Results-Flow-directed catheters were guided under MR fluoroscopy (1.5 T) into the RV for invasive pressure measurements. Simultaneously, ventricular volumes and myocardial mass were assessed from cine MRI. From sampled data, RV pressure-volume loops were constructed, and maximal ventricular elastance indexed to myocardial mass (E max_i ) was derived by use of a single-beat estimation method. This MRI method was first validated in vivo (6 swine), with conductance techniques used as reference. Bland-Altman test showed good agreement between methods (E max_i ϭ5.1Ϯ0.5 versus 5.8Ϯ0.7 mm Hg · mL Ϫ1 · 100 g

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Section: Assessment Of Rv and LV Volumes And Myocardial Massmentioning

confidence: 99%

“…8 Increased ventricular mass was defined as a measure of ventricular hypertrophy. Myocardial mass was determined separately for the interventricular septum, RV, and LV free wall.…”

Section: Myocardial Hypertrophy and Rv Fiber Stressmentioning

confidence: 99%

mentioning

confidence: 99%

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Magnetic Resonance Imaging Analysis of Right Ventricular Pressure-Volume Loops

Küehne

Yilmaz²,

Steendijk³

et al. 2004

Circulation

330

125

View full text Add to dashboard Cite

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“…In the long-term care of patients after atrial redirection surgery, clinicians are eager to understand the pathophysiology of reported late RV dysfunction, 8,9 reduced exercise capacity, 10 arrhythmia, and mortality from sudden cardiac death. [11][12][13] Multiple mechanisms for RV dysfunction late after atrial switch have been postulated.…”

Section: Introductionmentioning

confidence: 99%

Late Gadolinium Enhancement Cardiovascular Magnetic Resonance of the Systemic Right Ventricle in Adults With Previous Atrial Redirection Surgery for Transposition of the Great Arteries

et al. 2005

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Background-Patients treated for transposition of the great arteries by atrial redirection surgery have a right ventricle (RV) that sustains systemic pressures long term. Late RV dysfunction occurs in these patients; the reasons for this are unclear, but myocardial fibrosis may be important. Myocardial fibrosis can be visualized by late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR). We hypothesized that LGE would be present in the systemic RV and relate to adverse clinical features. Methods and Results-We performed CMR on 36 consecutive adult patients (mean age, 27 years) after atrial redirection surgery for transposition of the great arteries. Late gadolinium RV enhancement was seen in 22 patients (61%) with various patterns. Patients with RV LGE were older (30 versus 22 years; PϽ0.001) and had increased RV end-systolic volume index (43 versus 35 mL/m 2 ; Pϭ0.03), decreased RV ejection fraction (57% versus 62%; Pϭ0.02), increased QRS duration (108 versus 97 ms; Pϭ0.01), and increased QT dispersion (93 versus 71 ms; Pϭ0.002). The extent of LGE correlated with age (rϭ0.59, PϽ0.001) and QRS duration (rϭ0.67, PϽ0.001) and inversely with RV ejection fraction (rϭϪ0.76, PϽ0.001). The incidence of documented arrhythmia and/or syncope (10 of 36) was significantly higher in the late gadolinium-positive group (9/22 versus 1/14; Pϭ0.03). Key Words: heart ventricles Ⅲ magnetic resonance imaging Ⅲ heart defects, congenital Ⅲ transposition of great vessels Ⅲ fibrosis B efore use of the arterial switch operation, patients with transposition of the great arteries were palliated by redirection of blood at the atrial level with the Senning 1 or Mustard operation. 2 There is a contemporary adult population in whom the right ventricle (RV) must sustain systemic pressure long term. Late RV dysfunction is common in these patients 3 and may be related to myocardial fibrosis. In patients with a systemic left ventricle (LV), cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE) can detect myocardial fibrosis in both ischemic and nonischemic cardiomyopathies. 4,5 We hypothesized that LGE would be present in the systemic RV and that it would be associated with markers of adverse clinical outcome. 4 Conclusions-LGE Methods Patient PopulationConsecutive patients with transposition of the great arteries who had undergone either the Mustard or Senning procedure were invited to participate. Patients with a permanent pacemaker in situ were excluded. The local research ethics committee approved the study, and all patients gave written informed consent. Cardiovascular Magnetic ResonanceA 1.5-T scanner was used (Siemens Sonata). After routine assessment of anatomy, the patency of atrial pathways and function of valves were assessed by steady-state free precession (SSFP) cine imaging in a sequence of specified oblique planes. They were aligned with each atrial pathway, the inflow valves in long-axis planes, and the outflow tracts. Peak velocity was measured at the narrowest point of each caval pathwa...

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“…THERE IS INCREASING DEMAND for an accurate method to evaluate right ventricular volumes and function, both in ischemic heart disease and in the follow-up of patients with congenital heart disease (CHD) (1)(2)(3)(4)(5). Established imaging modalities, such as echocardiography and tomographic-gated blood pool scintigraphy, are limited by the complex shape of the right ventricle (3,6).…”

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confidence: 99%

Comparison of right ventricular volume measurement between segmented k‐space gradient‐echo and steady‐state free precession magnetic resonance imaging

Alfakih

Thiele

Plein

et al. 2002

Magnetic Resonance Imaging

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Purpose:To compare right ventricular volume measurements and their reproducibility between steady-state free precession (SSFP) and conventional turbo gradient-echo (TGE) imaging. Materials and Methods:Right ventricular volumes and observer variabilities were compared between SSFP and TGE in 31 subjects (21 normal volunteers and 10 subjects with heart failure). For further internal validation of the right ventricular volumes, the left ventricle (LV) and right ventricle (RV) stroke volumes were compared for the normal volunteers. Results:The volumes as measured by SSFP were significantly larger than for TGE (mean bias end-diastolic volume [EDV] 11.1 Ϯ 14.2, end-systolic volume [ESV] 9.8 Ϯ 9.75). SSFP had lower interobserver variability (SSFP EDV -10.1 Ϯ 11.6 vs. TGE EDV -6.2 Ϯ 18.5) and intra-observer variability (SSFP EDV -2.0 Ϯ 6.3 vs. TGE EDV -6.1 Ϯ 14.8). The mean absolute differences between LV and RV stroke volumes for 21 normal volunteers were: TGE 5.8 Ϯ 12.9 (r 2 ϭ 0.72), SSFP 4.6 Ϯ 6.9 (r 2 ϭ 0.92).Conclusion: SSFP and TGE yield different measurement values of RV volumes with SSFP, providing a more reproducible measurement.

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Right Ventricular Performance and Mass by Use of Cine MRI Late After Atrial Repair of Transposition of the Great Arteries

Cited by 115 publications

References 22 publications

Magnetic Resonance Imaging Analysis of Right Ventricular Pressure-Volume Loops

Magnetic Resonance Imaging Analysis of Right Ventricular Pressure-Volume Loops

Late Gadolinium Enhancement Cardiovascular Magnetic Resonance of the Systemic Right Ventricle in Adults With Previous Atrial Redirection Surgery for Transposition of the Great Arteries

Comparison of right ventricular volume measurement between segmented k‐space gradient‐echo and steady‐state free precession magnetic resonance imaging

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