@Article{chd.12861,
AUTHOR = {Margaret M. Samyn, Ke Yan, Conor Masterson, Benjamin H. Goot, David Saudek, Julie Lavoie, Aaron Kinney, Mary Krolikowski, Kan Hor, Scott Cohen},
TITLE = {Echocardiography vs cardiac magnetic resonance imaging assessment of the systemic right ventricle for patients with d-transposition of the great arteries status post atrial switch},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {6},
PAGES = {1138--1148},
URL = {http://www.techscience.com/schd/v14n6/38930},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> Patients with Dextro-transposition of the great arteries status post atrial 
switch (dTGA s/p atrial switch) are “at-risk” for systemic right ventricular (RV) dysfunction. Due to complex RV geometry, echocardiography (Echo) does not allow 
accurate determination of ejection fraction (EF), but cardiac magnetic resonance imaging (CMR) allows quantitative right ventricular assessment. Measures of ventricular 
deformation may be precursors to global ventricular dysfunction. The primary aim 
of this study was to characterize imaging and clinical findings for adult patients with 
dTGA s/p atrial switch.<br/>
<b>Design:</b> This was a retrospective cohort study of patients with dTGA s/p atrial 
switch operation (February 1966 to August 1988) with CMR performed at Children’s 
Hospital of Wisconsin (from September 2005 to May 2015). Eligible patients had 
clinic visit, Echo, and exercise stress test within 1 year of CMR.<br/>
<b>Results:</b> This study enrolled twenty-seven patients (16 males, 11 females) with dTGA 
s/p atrial switch (18 with Mustard operation and 9 with Senning operation; median 
age 30 years; 74% New York Heart Association class 1 and 26% class 2). Seventy-four 
percentage had normal RV systolic function (RV EF >45% by CMR). No correlation 
was observed between Echo strain data and clinical status (EF, exercise endurance, 
VO2 max, or New York Heart Association class). Cardiac magnetic resonance imaging 
RV global circumferential strain GCS and RV EF had moderate negative correlation 
(r = −0.65, P < .001). Global circumferential strain was significantly different for those 
with RV EF above and below 45%, while global peak longitudinal strain (GLS) was not. 
Patients had reduced CMR myocardial strain values compared with healthy controls.<br/>
<b>Conclusions:</b> Reduced RV CMR GCS (for those with RV EF <45%) suggests that CMR 
evaluation may enhance early detection of detrimental changes in the systemic RV 
myocardium.},
DOI = {10.1111/chd.12861}
}