@Article{chd.12472,
AUTHOR = {Magalie Ladouceur, Nadjia Kachenoura, Gilles Soulat, Emilie Bollache, Alban Redheuil, Michel Azizi, Christophe Delclaux, Gilles Chatellier, Pierre Boutouyrie, Laurence Iserin, Damien Bonnet, Elie Mousseaux},
TITLE = {Impaired atrioventricular transport in patients with transposition of the great arteries palliated by atrial switch and preserved systolic right ventricular function: A magnetic resonance imaging study},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {12},
YEAR = {2017},
NUMBER = {4},
PAGES = {458--466},
URL = {http://www.techscience.com/schd/v12n4/39179},
ISSN = {3071-1738},
ABSTRACT = {<b>Objectives:</b> We aimed (1) determine if systemic right ventricle filling parameters influence
systemic right ventricle stroke volume in adult patients with D-transposition of the great arteries
(D-TGA) palliated by atrial switch, using cardiac magnetic resonance imaging and echocardiography, and (2) to study relationship of these diastolic parameters with exercise performance and
BNP, in patients with preserved systolic systemic right ventricle function.<br/>
<b>Design:</b> Single-center, cross-sectional, prospective study.<br/>
<b>Setting:</b> In patients with D-TGA palliated by atrial switch, diastolic dysfunction of the systemic
right ventricle may precede systolic dysfunction.<br/>
<b>Methods:</b> Forty-five patients with D-TGA and atrial switch and 45 age and sex-matched healthy
subjects underwent cardiac magnetic resonance imaging and echocardiography. Filling flow-rates
measured by phase-contrast cardiac magnetic resonance imaging were analyzed using customized
software to estimate diastolic parameters and compared with exercise performance.<br/>
<b>Results:</b> In D-TGA, early filling of systemic right ventricle was impaired with a lower peak filling
rate normalized by filling volume (Ef/FV measured by cardiac magnetic resonance imaging) and a
higher early filling peak velocity normalized by early peak myocardial velocity (EUS/Ea measured by
echocardiography) compared with controls (P ≤ .04). Stroke volume of systemic right ventricle
showed a direct and significant association with pulmonary venous pathway size (respectively
r = 0.50, P< .01). Systemic right atrial area and systemic right ventricle mass/volume index measured by cardiac magnetic resonance imaging, as well as Ef/FV were significantly correlated with
exercise performances and BNP (P < .01). All correlations were independent of age, gender, body
mass index and blood pressure.<br/>
<b>Conclusions:</b> Systemic right ventricle pre-load and stroke volume depend mainly on intraatrial
pathway function. Moreover, systemic right ventricle remodeling and right atrial dysfunction
impair systemic right ventricle filling, leading to BNP increase and exercise limitation. Cardiac magnetic resonance imaging should assess systemic right ventricle filling abnormalities in D-TGA
patients.},
DOI = {10.1111/chd.12472}
}