Skip to main content
Erschienen in: Pediatric Cardiology 7/2019

25.07.2019 | Original Article

Differential Myocardial Mechanics in Volume and Pressure Loaded Right Ventricles Demonstrated by Cardiac Magnetic Resonance

verfasst von: Karena Wu, Sunkyung Yu, Adam L. Dorfman, Ray Lowery, Prachi P. Agarwal, Maryam Ghadimi Mahani, Jimmy C. Lu

Erschienen in: Pediatric Cardiology | Ausgabe 7/2019

Einloggen, um Zugang zu erhalten

Abstract

In patients with D-looped transposition of the great arteries (D-TGA) status post atrial switch operation, the systemic right ventricle (RV) shifts to predominantly circumferential (CS) rather than longitudinal strain (LS), which may represent adaptation or dysfunction. We aimed to evaluate myocardial mechanics in pressure loaded, volume-loaded, and normal RVs by cardiac magnetic resonance (CMR). Patients with D-TGA post atrial switch operation with CMR from 2008 to 2015 were matched 1:1 for age and RV ejection fraction (EF) with repaired tetralogy of Fallot (TOF) patients (volume-loaded RVs), and 1:1 for age with control patients. RV free wall LS and CS were measured using feature tracking software (TomTec, Unterscleissheim, Germany). A total of 32 D-TGA (median age 32 years, 56% male), 32 TOF, and 32 control patients were included. D-TGA patients had less dilatation than TOF patients (125 ± 35 ml/m2 vs. 149 ± 44 ml/m2, p = 0.02) and lower RVEF than controls (42.9 ± 7.7% vs. 56.3 ± 5.6%, p < 0.0001). RV LS was similar in D-TGA and TOF ( − 13.2 ± 4.5% vs. − 14.5 ± 5.9%, p = 0.32), both decreased compared to controls. However, CS in D-TGA was higher than controls ( − 14.1 ± 4.1% vs. − 11.4 ± 4.4%, p = 0.01), with a higher CS:LS ratio (1.2 ± 0.7 vs. 0.6 ± 0.3, p < 0.0001), while CS in TOF and controls did not differ. RVEF in D-TGA correlated closely with CS (r =  − 0.85, p < 0.0001) but not LS (r = 0.10, p = 0.58). I n conclusion, CMR can differentiate strain patterns in pressure- and volume-loaded RVs, with decreased LS in both conditions, while systemic RVs compensate with supra-normal CS. CS may be a more clinically relevant measure of RV function in this population.
Literatur
1.
Zurück zum Zitat Cuypers JA, Eindhoven JA, Slager MA, Opic P, Utens EM, Helbing WA, Witsenburg M, van den Bosch AE, Ouhlous M, van Domburg RT, Rizopoulos D, Meijboom FJ, Bogers AJ, Roos-Hesselink JW (2014) The natural and unnatural history of the Mustard procedure: long-term outcome up to 40 years. Eur Heart J 35(25):1666–1674. https://doi.org/10.1093/eurheartj/ehu102 CrossRefPubMed Cuypers JA, Eindhoven JA, Slager MA, Opic P, Utens EM, Helbing WA, Witsenburg M, van den Bosch AE, Ouhlous M, van Domburg RT, Rizopoulos D, Meijboom FJ, Bogers AJ, Roos-Hesselink JW (2014) The natural and unnatural history of the Mustard procedure: long-term outcome up to 40 years. Eur Heart J 35(25):1666–1674. https://​doi.​org/​10.​1093/​eurheartj/​ehu102 CrossRefPubMed
2.
Zurück zum Zitat Roos-Hesselink JW, Meijboom FJ, Spitaels SE, van Domburg R, van Rijen EH, Utens EM, McGhie J, Bos E, Bogers AJ, Simoons ML (2004) Decline in ventricular function and clinical condition after Mustard repair for transposition of the great arteries (a prospective study of 22–29 years). Eur Heart J 25(14):1264–1270. https://doi.org/10.1016/j.ehj.2004.03.009 CrossRefPubMed Roos-Hesselink JW, Meijboom FJ, Spitaels SE, van Domburg R, van Rijen EH, Utens EM, McGhie J, Bos E, Bogers AJ, Simoons ML (2004) Decline in ventricular function and clinical condition after Mustard repair for transposition of the great arteries (a prospective study of 22–29 years). Eur Heart J 25(14):1264–1270. https://​doi.​org/​10.​1016/​j.​ehj.​2004.​03.​009 CrossRefPubMed
3.
Zurück zum Zitat Piran S, Veldtman G, Siu S, Webb GD, Liu PP (2002) Heart failure and ventricular dysfunction in patients with single or systemic right ventricles. Circulation 105(10):1189–1194CrossRefPubMed Piran S, Veldtman G, Siu S, Webb GD, Liu PP (2002) Heart failure and ventricular dysfunction in patients with single or systemic right ventricles. Circulation 105(10):1189–1194CrossRefPubMed
4.
Zurück zum Zitat Orwat S, Diller GP, Kempny A, Radke R, Peters B, Kuhne T, Boethig D, Gutberlet M, Dubowy KO, Beerbaum P, Sarikouch S, Baumgartner H, German Competence Network for Congenital Heart Defects I (2016) Myocardial deformation parameters predict outcome in patients with repaired tetralogy of fallot. Heart 102(3):209–215. https://doi.org/10.1136/heartjnl-2015-308569 CrossRefPubMed Orwat S, Diller GP, Kempny A, Radke R, Peters B, Kuhne T, Boethig D, Gutberlet M, Dubowy KO, Beerbaum P, Sarikouch S, Baumgartner H, German Competence Network for Congenital Heart Defects I (2016) Myocardial deformation parameters predict outcome in patients with repaired tetralogy of fallot. Heart 102(3):209–215. https://​doi.​org/​10.​1136/​heartjnl-2015-308569 CrossRefPubMed
6.
Zurück zum Zitat Diller GP, Radojevic J, Kempny A, Alonso-Gonzalez R, Emmanouil L, Orwat S, Swan L, Uebing A, Li W, Dimopoulos K, Gatzoulis MA, Baumgartner H (2012) Systemic right ventricular longitudinal strain is reduced in adults with transposition of the great arteries, relates to subpulmonary ventricular function, and predicts adverse clinical outcome. Am Heart J 163(5):859–866. https://doi.org/10.1016/j.ahj.2012.01.038 CrossRefPubMed Diller GP, Radojevic J, Kempny A, Alonso-Gonzalez R, Emmanouil L, Orwat S, Swan L, Uebing A, Li W, Dimopoulos K, Gatzoulis MA, Baumgartner H (2012) Systemic right ventricular longitudinal strain is reduced in adults with transposition of the great arteries, relates to subpulmonary ventricular function, and predicts adverse clinical outcome. Am Heart J 163(5):859–866. https://​doi.​org/​10.​1016/​j.​ahj.​2012.​01.​038 CrossRefPubMed
7.
Zurück zum Zitat Kalogeropoulos AP, Deka A, Border W, Pernetz MA, Georgiopoulou VV, Kiani J, McConnell M, Lerakis S, Butler J, Martin RP, Book WM (2012) Right ventricular function with standard and speckle-tracking echocardiography and clinical events in adults with D-transposition of the great arteries post atrial switch. J Am Soc Echocardiogr 25(3):304–312. https://doi.org/10.1016/j.echo.2011.12.003 CrossRefPubMed Kalogeropoulos AP, Deka A, Border W, Pernetz MA, Georgiopoulou VV, Kiani J, McConnell M, Lerakis S, Butler J, Martin RP, Book WM (2012) Right ventricular function with standard and speckle-tracking echocardiography and clinical events in adults with D-transposition of the great arteries post atrial switch. J Am Soc Echocardiogr 25(3):304–312. https://​doi.​org/​10.​1016/​j.​echo.​2011.​12.​003 CrossRefPubMed
9.
10.
Zurück zum Zitat Schulz-Menger J, Bluemke DA, Bremerich J, Flamm SD, Fogel MA, Friedrich MG, Kim RJ, von Knobelsdorff-Brenkenhoff F, Kramer CM, Pennell DJ, Plein S, Nagel E (2013) Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) board of trustees task force on standardized post processing. J Cardiovasc Magn Reson 15:35. https://doi.org/10.1186/1532-429X-15-35 CrossRefPubMedPubMedCentral Schulz-Menger J, Bluemke DA, Bremerich J, Flamm SD, Fogel MA, Friedrich MG, Kim RJ, von Knobelsdorff-Brenkenhoff F, Kramer CM, Pennell DJ, Plein S, Nagel E (2013) Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) board of trustees task force on standardized post processing. J Cardiovasc Magn Reson 15:35. https://​doi.​org/​10.​1186/​1532-429X-15-35 CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Lang RM, Badona LP, Mov-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28(1):1–39e14. https://doi.org/10.1016/j.echo.2014.10.003 CrossRef Lang RM, Badona LP, Mov-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28(1):1–39e14. https://​doi.​org/​10.​1016/​j.​echo.​2014.​10.​003 CrossRef
14.
Zurück zum Zitat Ladouceur M, Redheuil A, Soulat G, Delclaux C, Azizi M, Patel M, Chatellier G, Legendre A, Iserin L, Boudjemline Y, Bonnet D, Mousseaux E, Investigators S (2016) Longitudinal strain of systemic right ventricle correlates with exercise capacity in adult with transposition of the great arteries after atrial switch. Int J Cardiol 217:28–34. https://doi.org/10.1016/j.ijcard.2016.04.166 CrossRefPubMed Ladouceur M, Redheuil A, Soulat G, Delclaux C, Azizi M, Patel M, Chatellier G, Legendre A, Iserin L, Boudjemline Y, Bonnet D, Mousseaux E, Investigators S (2016) Longitudinal strain of systemic right ventricle correlates with exercise capacity in adult with transposition of the great arteries after atrial switch. Int J Cardiol 217:28–34. https://​doi.​org/​10.​1016/​j.​ijcard.​2016.​04.​166 CrossRefPubMed
15.
Zurück zum Zitat Giardini A, Lovato L, Donti A, Formigari R, Oppido G, Gargiulo G, Picchio FM, Fattori R (2006) Relation between right ventricular structural alterations and markers of adverse clinical outcome in adults with systemic right ventricle and either congenital complete (after Senning operation) or congenitally corrected transposition of the great arteries. Am J Cardiol 98(9):1277–1282. https://doi.org/10.1016/j.amjcard.2006.05.062 CrossRefPubMed Giardini A, Lovato L, Donti A, Formigari R, Oppido G, Gargiulo G, Picchio FM, Fattori R (2006) Relation between right ventricular structural alterations and markers of adverse clinical outcome in adults with systemic right ventricle and either congenital complete (after Senning operation) or congenitally corrected transposition of the great arteries. Am J Cardiol 98(9):1277–1282. https://​doi.​org/​10.​1016/​j.​amjcard.​2006.​05.​062 CrossRefPubMed
16.
Zurück zum Zitat Grothoff M, Fleischer A, Abdul-Khaliq H, Hoffmann J, Lehmkuhl L, Luecke C, Gutberlet M (2013) 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. Cardiol Young 23(2):239–247. https://doi.org/10.1017/S1047951112000790 CrossRefPubMed Grothoff M, Fleischer A, Abdul-Khaliq H, Hoffmann J, Lehmkuhl L, Luecke C, Gutberlet M (2013) 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. Cardiol Young 23(2):239–247. https://​doi.​org/​10.​1017/​S104795111200079​0 CrossRefPubMed
22.
23.
Metadaten
Titel
Differential Myocardial Mechanics in Volume and Pressure Loaded Right Ventricles Demonstrated by Cardiac Magnetic Resonance
verfasst von
Karena Wu
Sunkyung Yu
Adam L. Dorfman
Ray Lowery
Prachi P. Agarwal
Maryam Ghadimi Mahani
Jimmy C. Lu
Publikationsdatum
25.07.2019
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 7/2019
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-019-02175-3

Weitere Artikel der Ausgabe 7/2019

Pediatric Cardiology 7/2019 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.