https://doi.org/10.4081/monaldi.2024.3085

Multimodality imaging and functional assessment in patients with systemic right ventricle and biventricular physiology: a retrospective single-center study

Early Access
Submitted: June 16, 2024
Accepted: August 3, 2024
Published: September 23, 2024
Systemic right ventricle, cardiac magnetic resonance imaging, cardiopulmonary exercise test, echocardiography
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PDF_EARLY VIEW: 29
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Authors

Alice Pozza
https://orcid.org/0009-0003-4799-5551
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua, Italy.
Martina Avesani
martina.avesani@aopd.veneto.it
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua, Italy.
Irene Cattapan
https://orcid.org/0000-0001-8357-4322
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua, Italy.
Elena Reffo
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua, Italy.
Annachiara Cavaliere
https://orcid.org/0000-0002-5636-3316
Pediatric Radiology, Neuroradiology Unit, University Hospital of Padua, Italy.
Jolanda Sabatino
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua; Pediatric Cardiology Unit, Magna Graecia University, Catanzaro, Italy.
Sofia Piana
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua, Italy.
Anna Molinaroli
https://orcid.org/0009-0003-6491-3247
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua, Italy.
Domenico Sirico
https://orcid.org/0000-0002-6444-2292
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua, Italy.
Biagio Castaldi
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua, Italy.
Alessia Cerutti
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua, Italy.
Roberta Biffanti
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua, Italy.
Giovanni di Salvo
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua, Italy.

Systemic right ventricle (sRV) dysfunction is frequent in patients with congenitally corrected transposition of great arteries (cc-TGA) and those with dextro-transposition of great arteries (D-TGA) after Mustard/Senning operations. This condition should be identified promptly. We aimed to compare echocardiographic parameters with cardiac magnetic resonance (CMR)-derived parameters in patients with sRV and to evaluate their correlation with clinical variables and exercise capacity. Patients with cc-TGA and D-TGA after Mustard/Senning who underwent standard and advanced (speckle tracking and 3D) echocardiography and CMR (including feature-speckle tracking) were included. Clinical and imaging parameters were collected. Echocardiographic-derived right ventricle end-diastolic area and end-systolic area correlated with 3D echocardiographic-derived right ventricle end-diastolic and end-systolic volume (r=0.6, p=0.006 and r=0.8, p=0.002). 3D ejection fraction (EF) correlated with fractional area change and tricuspid annular plane systolic excursion (TAPSE) (r=0.8, p=0.001 and r=0.7, p=0.03). sRV global longitudinal strain correlated with systemic atrial strain (sAS) (r=-0.6, p=0.01). CMR-derived EF correlated with CMR-derived global longitudinal strain (GLS) both endocardial and myocardial (r=-0.7, p=0.007 and r=-0.6, p=0.005). sRV areas as assessed by echo correlated with CMR-derived volumes (r=0.9, p=0.0001 for diastole and r=0.8, p=0.0001 for systole). Similarly, a correlation was found between sRV echo-derived GLS and CMR-derived GLS, both endocardial and myocardial (r=0.8, p=0.001 and r=0.7, p=0.01). The only imaging parameter which correlated with peak V02 was sAS (r=0.55, p=0.04). When comparing cc-TGA and D-TGA, the former showed better GLS-derived values as assessed by CMR (CMR-derived right ventricle endocardial longitudinal strain -23.2% versus -17.2%, p=0.002; CMR-derived right ventricle myocardial longitudinal strain -21.2% versus -16.7%; p=0.05), bigger systemic atrial area (20.2 cm2/m2 versus 8.4 cm2/m2, p=0.005) and higher TAPSE values (16.2 mm versus 12.2 mm, p=0.04). Echocardiography is valid to screen for sRV dilatation and function and to guide the timing for CMR. The investigation of atrial deformation imaging may help to better understand diastolic function. Patients with cc-TGA show better cardiac function compared to patients after atrial switch. Further investigations are needed to identify imaging parameters linked to exercise capacity.

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How to Cite

Pozza, Alice, Martina Avesani, Irene Cattapan, Elena Reffo, Annachiara Cavaliere, Jolanda Sabatino, Sofia Piana, Anna Molinaroli, Domenico Sirico, Biagio Castaldi, Alessia Cerutti, Roberta Biffanti, and Giovanni di Salvo. 2024. “Multimodality Imaging and Functional Assessment in Patients With Systemic Right Ventricle and Biventricular Physiology: A Retrospective Single-Center Study”. Monaldi Archives for Chest Disease, September. https://doi.org/10.4081/monaldi.2024.3085.
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