Abstract Background We tested the hypothesis that diastolic ventricular interaction occurs after atrial switch operation for transposition of the great arteries (TGA) and that subpulmonary LV diastolic function is influenced by septal geometry. Methods Twenty-nine patients (male 19) after atrial switch operation for TGA aged 20.8±4.1years and 27 healthy controls were studied. Two-dimensional longitudinal systolic strain, systolic (SRs), early diastolic (SRe), and late diastolic (SRa) strain rates of both ventricles were determined using speckle tracking echocardiography. Early diastolic trans-atrioventricular velocity (E) and myocardial early diastolic myocardial velocity (e) at the ventricular free wall–annular junction were measured. Geometry of the morphologic left ventricle was quantified by the diastolic eccentricity index (EI). Results In both systemic and subpulmonary ventricles, SRe and SRa were significantly lower and trans-atrioventricular E/e ratios higher in patients than controls (all p r =0.49, p =0.008), and RV SRa correlated with LV SRa ( r =0.46, p =0.01). Significant leftward shifting of the septum in patients was reflected by the greater LV EI ( p r =−0.62, p r =−0.51, p r =0.33, p =0.02). Conclusions Systemic RV diastolic dysfunction occurs after atrial switch operation and correlates with subpulmonary LV diastolic dysfunction. The observed diastolic ventricular interaction may potentially be mediated through alteration of septal geometry.
Background— We tested the hypothesis that right ventricular (RV) pressure overload affects RV function and further influences left ventricular (LV) geometry, which adversely affects LV twist mechanics and segmental function. Methods and Results— Echocardiographic images were prospectively acquired in 44 patients (age, 46±12 years; 82% women) with evidence of pulmonary hypertension (estimated pulmonary artery systolic pressure, 71±23 mm Hg) and in 44 age- and gender-matched healthy subjects. Pati...
#1Philipp Lurz(ICH: UCL Institute of Child Health)H-Index: 47
#2Rajesh Puranik(ICH: UCL Institute of Child Health)H-Index: 21
Last. Andrew M. Taylor(ICH: UCL Institute of Child Health)H-Index: 95
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Aims To investigate the impact of relief of right ventricle (RV) to pulmonary artery (PA) conduit obstruction on septal motion and ventricular interaction and its functional implications for left ventricular (LV) filling properties. Methods and results In 20 consecutive patients with congenital heart disease and RV to PA conduit obstruction, the following were prospectively assessed before and after percutaneous pulmonary valve implantation (PPVI): the septal curvature and LV volumes throughout ...
Abstract Echocardiographic strain and strain rate imaging is a new technology enabling more reliable and comprehensive assessment of myocardial function. The spectrum of potential clinical applications is very wide due to its ability to differentiate between active and passive movement of myocardial segments, to quantify intraventricular dyssynchrony and to evaluate components of myocardial function, such as longitudinal myocardial shortening, that are not visually assessable. The high sensitivi...
Background Knowledge about age-specific normal values for left ventricular mass (LVM), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF) by cardiac magnetic resonance imaging (CMR) is of importance to differentiate between health and disease and to assess the severity of disease. The aims of the study were to determine age and gender specific normal reference values and to explore the normal physiological variation of these parameters from adole...
Abstract Principles of Ethical Publishing in the International Journal of Cardiology: 1.That the corresponding author has the approval of all other listed authors for the submission and publication of all versions of the manuscript. 2.That all people who have a right to be recognised as authors have been included on the list of authors and everyone listed as an author has made an independent material contribution to the manuscript 3.That the work submitted in the manuscript is original and has n...
Last. Yiu-fai Cheung(HKU: University of Hong Kong)H-Index: 37
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Objectives: To determine the usefulness of new two-dimensional strain indices, based on speckle tracking imaging, for assessment of systemic right ventricular (RV) function after an atrial switch operation for transposition of the great arteries. Design: Cross-sectional study. Setting: Tertiary paediatric cardiac centre. Methods: 26 patients, mean (SD) age 21.0 (3.6) years at 19.9 (3.2) years after an atrial switch operation, and 27 age-matched controls were studied. Two-dimensional imaging at t...
In patients operated with atrial switch for transposition of the great arteries (TGA), the left ventricle (LV) supports the pulmonary circulation and is thus pressure unloaded. Evaluation of LV function in this setting is of importance, as LV functional abnormalities have been documented and might contribute to development of symptoms. The ventricular contraction pattern in 14 Senning-operated TGA patients and 14 healthy controls was studied using tissue Doppler and magnetic resonance imaging. I...
Last. Raoul Arnold(Boston Children's Hospital)H-Index: 2
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Objective The aim of this study was to investigate regional myocardial function after atrial switch operation for transposition of the great arteries (TGA) using tissue Doppler echocardiography with strain rate (SR) imaging. Methods In all, 24 patients with TGA aged 12 to 33 years and 10 control subjects underwent tissue Doppler echocardiography/SR imaging at rest and during bicycle exercise at 1 and 2 W/kg. Longitudinal function was quantified by strain, SR, and peak velocities measured in the ...
Background Few data are available on the evaluation of right ventricular (RV) diastolic function and filling pressures by echocardiography. We aimed to determine whether the ratio of early tricuspid inflow to annular diastolic velocity (E/E') could be used to estimate RV filling pressure in patients with and without recent cardiac surgery. Methods In all, 101 data sets including invasive and echocardiographic measurements (42 after recent cardiac surgery) were simultaneously obtained from patien...
Aims: This study investigated whether right ventricular (RV) diastolic function is impaired in pulmonary hypertension (PH) patients, and whether it is related to RV mass and afterload. In addition, the effects of an acute reduction of RV afterload by the oral intake of sildenafil were studied. Finally, we assessed whether diastolic function is related to cardiac parameters of disease severity. Methods and results: Twenty-five PH patients and 11 control subjects were studied. Right-heart catheter...
Objective To assess the prevalence of elevated systemic right ventricular (sRV) end-diastolic pressure and pulmonary arterial hypertension in adults with transposition of the great arteries (TGA) who have undergone atrial switch operation. Methods Forty-two adults (aged ≥18 years) with complete TGA and atrial switch palliation undergoing cardiac catheterisation between 2004 and 2018 at Mayo Clinic, MN, were identified. Clinical, echocardiographic and invasive haemodynamic data were abstracted fr...
Last. Pak-Cheong Chow(HKU: University of Hong Kong)H-Index: 9
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Abstract Background This study aimed to assess diffuse myocardial fibrosis of the systemic right ventricle and subpulmonary left ventricle in patients after Senning or Mustard operation for complete transposition of the great artery (TGA) using cardiac magnetic resonance (CMR) T1 mapping. Methods Thirty-one adult TGA patients after Senning (n = 24) or Mustard (n = 7) operation were studied at the age of 33.3 ± 4.0 years. Systemic right ventricular (RV) and subpulmonary left ventricular (LV) volu...
Heart failure with reduced ejection fraction (HFrEF) is common in patients with adult congenital heart disease. Many of the most common congenital defects have a high prevalence of HFrEF, including left-sided obstructive lesions (aortic stenosis, coarctation of the aorta, Shone complex), tetralogy of Fallot, Ebstein anomaly, lesions in which there is a systemic right ventricle, and lesions palliated with a Fontan circulation. However, heart failure with preserved ejection fraction (HFpEF) is als...
Last. Yiu-fai Cheung(HKU: University of Hong Kong)H-Index: 37
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BACKGROUND: The QRS-T angle has been associated with adverse cardiovascular events and sudden cardiac deaths. We determined frontal QRS-T angle in patients with complete transposition of the great arteries (TGA) after atrial switch operation and repaired tetralogy of Fallot (TOF) and explored its relationships with ventricular mechanics. METHODS: Thirty TGA patients aged 32.3 +/- 4.4 years after atrial switch operation and 47 repaired TOF patients aged 28.7 +/- 6.0 years were studied. The fronta...
Management of congenital heart disease (CHD) in adults (ACHD) remains an ongoing challenge due to the presence of residual hemodynamic lesions and development of ventricular dysfunction in a large number of patients. Echocardiographic imaging plays a central role in clinical decision-making and selection of patients who will benefit most from catheter interventions or cardiac surgery.. Recent advances in both strain imaging and three-dimensional (3D)-echocardiography have significantly contribut...
#2Stéphanie Baron(Paris V: Paris Descartes University)H-Index: 15
Last. Elie Mousseaux(Paris V: Paris Descartes University)H-Index: 32
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Abstract Background Heart failure is a serious event in patients with transposition of the great arteries (D-TGA) after atrial redirection surgery. We aimed to determine the association between myocardial fibrosis and systolic and diastolic systemic right ventricle (sRV) dysfunction. Methods Diastolic and systolic function of sRV was prospectively assessed using echocardiography and cardiac magnetic resonance imaging (CMR) in 48 patients with atrially switched D-TGA and 26 healthy subjects. Dias...
Abstract The impact of one ventricle on the adjacent ventricle plays a key role in cardiac function. Ventricular-ventricular interactions are based on the arrangement in-series of the circulation and common pericardium, interventricular septum, and myocardial tracts. Imaging, in particular echocardiography, plays a central role in characterizing these interactions through geometric indices, septal configuration and motion, Doppler flow, timing of events in the ventricles and alterations in strai...
Last. Elie Mousseaux(Paris V: Paris Descartes University)H-Index: 32
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Objectives 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. Design Single-center, cross-sectional, prosp...
We describe of a unique pattern of cardiac dyssynchrony in a patient with a biventricular physiology and systemic right ventricle (RV): the interventricular dyssynchrony due to a contraction delay between the left ventricle and RV. In the present case, the cineangiography and intracardiac electrocardiography of the RV did not reveal intraventricular dyssynchrony of the RV, but revealed interventricular dyssynchrony. In addition, the pressure curves of the ventricles exhibited time phase differen...
#1Masamichi Ono(TUM: Technische Universität München)H-Index: 6
#2Manfred Vogt(TUM: Technische Universität München)H-Index: 23
Last. Rüdiger Lange(TUM: Technische Universität München)H-Index: 56
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Background After the Fontan-Bjork modification for tricuspid atresia, some patients show pulsatile systolic pulmonary flow. We compared the hemodynamic findings and the clinical presentation of patients with and without pulsatile systolic flow after atrioventricular connection. Methods According to the pulmonary flow pattern by pulsed-wave Doppler assessment of transthoracic echocardiography, 41 patients after atrioventricular connection were divided into two groups: patients who showed dominant...