Open AccessEvaluation of Right Ventricular Myocardial Mechanics Using V elocity V ector I maging of Cardiac MRI Cine Images in Transposition of the Great Arteries Following Atrial and Arterial Switch Operations
Author(s) -
Thattaliyath Bijoy D.,
Forsha Daniel E.,
Stewart Chad,
Barker Piers C.A.,
Campbell Michael J.
Publication year - 2015
Publication title -
congenital heart disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.828
H-Index - 42
eISSN - 1747-0803
pISSN - 1747-079X
DOI - 10.1111/chd.12250
Subject(s) - medicine , ventricle , cardiology , ejection fraction , great arteries , velocity vector , diastole , transposition (logic) , heart failure , blood pressure , geometry , mathematics , engineering , aerospace engineering
Abstract Objective The aim of the study was to determine right and left ventricle deformation parameters in patients with transposition of the great arteries who had undergone atrial or arterial switch procedures. Setting Patients with transposition are born with a systemic right ventricle. Historically, the atrial switch operation, in which the right ventricle remains the systemic ventricle, was performed. These patients have increased rates of morbidity and mortality. We used cardiac MRI with V elocity V ector I maging analysis to characterize and compare ventricular myocardial deformation in patients who had an atrial switch or arterial switch operation. Design Patients with a history of these procedures, who had a clinically ordered cardiac MRI were included in the study. Consecutive 20 patients (75% male, 28.7 ± 1.8 years) who underwent atrial switch operation and 20 patients (60% male, 17.7 ± 1.9 years) who underwent arterial switch operation were included in the study. Four chamber and short‐axis cine images were used to determine longitudinal and circumferential strain and strain rate using V ector V elocity I maging software. Results Compared with the arterial switch group, the atrial switch group had decreased right ventricular ejection fraction and increased end‐diastolic and end‐systolic volumes, and no difference in left ventricular ejection fraction and volumes. The atrial switch group had decreased longitudinal and circumferential strain and strain rate. When compared with normal controls multiple strain parameters in the atrial switch group were reduced. Conclusions Myocardial deformation analysis of transposition patients reveals a reduction of right ventricular function and decreased longitudinal and circumferential strain parameters in patients with an atrial switch operation compared with those with arterial switch operation. A better understanding of the mechanisms of right ventricle failure in transposition of great arteries may lead to improved therapies and adaptation.