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
Submitted: June 16, 2024
Accepted: August 3, 2024
Published: September 23, 2024
Accepted: August 3, 2024
Abstract Views: 523
PDF: 164
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
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 (GLS) correlated with systemic atrial strain (sAS) (r=-0.6, p=0.01). CMR-derived EF correlated with CMR-derived 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 that correlated with peak oxygen consumption 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.
Ho SY, Nihoyannopoulos P. Anatomy, echocardiography, and normal right ventricular dimensions. Heart 2006;92:i2-13.
DOI: https://doi.org/10.1136/hrt.2005.077875
Foschi M, Di Mauro M, Tancredi F, et al. The dark side of the moon: the right ventricle. J Cardiovasc Dev Dis 2017;4:18.
DOI: https://doi.org/10.3390/jcdd4040018
Morrison ML, Grant B, McCrossan BA, et al. 32 year follow up of patients following atrial redirection surgery for transposition of the great arteries. Congenit Heart Dis 2019;14:846-53.
DOI: https://doi.org/10.1111/chd.12822
Gelatt M, Hamilton RM, McCrindle BW, et al. Arrhythmia and mortality after the Mustard procedure: a 30-year single-center experience. J Am Coll Cardiol 1997;29:194-201.
DOI: https://doi.org/10.1016/S0735-1097(96)00424-X
Lebherz C, Gerhardus M, Lammers AE, et al. Late outcome, therapy and systemic ventricular function in patients with a systemic right ventricle: data of the German National Register for Congenital Heart Defects. Cardiol Young 2022;32:1235-45.
DOI: https://doi.org/10.1017/S1047951121003954
Ciuca C, Balducci A, Angeli E, et al. Long term follow-up of patients with systemic right ventricle and biventricular physiology: a single centre experience. J Cardiovasc Dev Dis 2023;10:219.
DOI: https://doi.org/10.3390/jcdd10050219
Brida M, Diller G-P, Gatzoulis MA. Systemic Right ventricle in adults with congenital heart disease: anatomic and phenotypic spectrum and current approach to management. Circulation 2018;137:508-18.
DOI: https://doi.org/10.1161/CIRCULATIONAHA.117.031544
Festa P, Lovato L, Bianco F, et al. Recommendations for cardiovascular magnetic resonance and computed tomography in congenital heart disease: a consensus paper from the CMR/CCT working group of the Italian Society of Pediatric Cardiology and the Italian College of Cardiac Radiology endorsed by the Italian Society of Medical and Interventional Radiology (part II). J Cardiovasc Med 2024;25:473-87.
DOI: https://doi.org/10.2459/JCM.0000000000001628
Iriart X, Horovitz A, Van Geldorp IE, et al. The role of echocardiography in the assessment of right ventricular systolic function in patients with transposition of the great arteries and atrial redirection. Arch Cardiovasc Dis 2012;105:432-41.
DOI: https://doi.org/10.1016/j.acvd.2012.05.005
Obokata M, Nagata Y, Wu VC-C, et al. Direct comparison of cardiac magnetic resonance feature tracking and 2D/3D echocardiography speckle tracking for evaluation of global left ventricular strain. Eur Heart J Cardiovasc Imaging 2016;17:525-32.
DOI: https://doi.org/10.1093/ehjci/jev227
Samyn MM, Yan K, Masterson C, et al. 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. Congenit Heart Dis 2019;14:1138-48.
DOI: https://doi.org/10.1111/chd.12861
Moscatelli S, Avesani M, Borrelli N, et al. Complete transposition of the great arteries in the pediatric field: a multimodality imaging approach. Children 2024;11:626.
DOI: https://doi.org/10.3390/children11060626
Lang RM, Badano LP, Mor-Avi V, et al. 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 2015;28:1-39.e14.
DOI: https://doi.org/10.1016/j.echo.2014.10.003
Sabatino J, Di Salvo G, Krupickova S, et al. Left ventricular twist mechanics to identify left ventricular noncompaction in childhood. Circ Cardiovasc Imaging 2019;12:e007805.
DOI: https://doi.org/10.1161/CIRCIMAGING.118.007805
Prota C, Di Salvo G, Sabatino J, et al. Prognostic value of echocardiographic parameters in pediatric patients with Ebstein’s anomaly. Int J Cardiol 2019;278:76-83.
DOI: https://doi.org/10.1016/j.ijcard.2018.10.046
Fratz S, Chung T, Greil GF, et al. Guidelines and protocols for cardiovascular magnetic resonance in children and adults with congenital heart disease: SCMR expert consensus group on congenital heart disease. J Cardiovasc Magn Reson 2013;15:51.
DOI: https://doi.org/10.1186/1532-429X-15-51
Gregov A, Hrabak Paar M. Magnetic resonance imaging assessment of right ventricular deformation in patients with transposition of the great arteries. J Thorac Imaging 2022;37:W85-91.
DOI: https://doi.org/10.1097/RTI.0000000000000662
Morais P, Marchi A, Bogaert JA, et al. Cardiovascular magnetic resonance myocardial feature tracking using a non-rigid, elastic image registration algorithm: assessment of variability in a real-life clinical setting. J Cardiovasc Magn Reson 2016;19:24.
DOI: https://doi.org/10.1186/s12968-017-0333-y
Rajiah PS, Kalisz K, Broncano J, et al. Myocardial strain evaluation with cardiovascular mri: physics, principles, and clinical applications. RadioGraphics 2022;42:968-90.
DOI: https://doi.org/10.1148/rg.210174
Scatteia A, Baritussio A, Bucciarelli-Ducci C. Strain imaging using cardiac magnetic resonance. Heart Fail Rev 2017;22:465-76.
DOI: https://doi.org/10.1007/s10741-017-9621-8
Helsen F, De Meester P, Van De Bruaene A, et al. Right ventricular systolic dysfunction at rest is not related to decreased exercise capacity in patients with a systemic right ventricle. Int J Cardiol 2018;260:66-71.
DOI: https://doi.org/10.1016/j.ijcard.2018.03.029
Molnár AÁ, Sánta A, Merkely B. Echocardiography imaging of the right ventricle: focus on three-dimensional echocardiography. Diagnostics 2023;13:2470.
DOI: https://doi.org/10.3390/diagnostics13152470
Kutty S, Li L, Polak A, et al. Echocardiographic knowledge-based reconstruction for quantification of the systemic right ventricle in young adults with repaired D-transposition of great arteries. Am J Cardiol 2012;109:881-8.
DOI: https://doi.org/10.1016/j.amjcard.2011.11.012
Schneider M, Beichl M, Nietsche C, et al. Systematic evaluation of systemic right ventricular function. J Clin Med 2019;9:107.
DOI: https://doi.org/10.3390/jcm9010107
Claus P, Omar AMS, Pedrizzetti G, et al. tissue tracking technology for assessing cardiac mechanics. JACC Cardiovasc Imaging 2015;8:1444-60.
DOI: https://doi.org/10.1016/j.jcmg.2015.11.001
Franzoso FD, Wohlmuth C, Greutmann M, et al. Atrial function after the atrial switch operation for transposition of the great arteries: comparison with arterial switch and normals by cardiovascular magnetic resonance. Congenit Heart Dis 2016;11:426-36.
DOI: https://doi.org/10.1111/chd.12323
Gaynor SL, Maniar HS, Prasad SM, et al. Reservoir and conduit function of right atrium: impact on right ventricular filling and cardiac output. Am J Physiol Heart Circ Physiol 2005;288:H2140-5.
DOI: https://doi.org/10.1152/ajpheart.00566.2004
Dorobantu DM, Amir NH, Wadey CA, et al. The role of speckle-tracking echocardiography in predicting mortality and morbidity in patients with congenital heart disease: a systematic review and meta-analysis. J Am Soc Echocardiogr 2024;37:216-25.
DOI: https://doi.org/10.1016/j.echo.2023.11.003
Gaynor SL, Maniar HS, Bloch JB, et al. Right atrial and ventricular adaptation to chronic right ventricular pressure overload. Circulation 2005;112:I212-8.
DOI: https://doi.org/10.1161/CIRCULATIONAHA.104.517789
Ta HT, Alsaied T, Steele JM, et al. Atrial function and its role in the non-invasive evaluation of diastolic function in congenital heart disease. Pediatr Cardiol 2020;41:654-68.
DOI: https://doi.org/10.1007/s00246-020-02351-w
Avesani M, Borrelli N, Krupickova S, et al. Echocardiography and cardiac magnetic resonance in children with repaired tetralogy of Fallot: new insights in cardiac mechanics and exercise capacity. Int J Cardiol 2020;321:144-9.
DOI: https://doi.org/10.1016/j.ijcard.2020.07.026
Rato J, Mendes SC, Sousa A, et al. The Influence of atrial strain on functional capacity in patients with the fontan circulation. Pediatr Cardiol 2020;41:1730-8.
DOI: https://doi.org/10.1007/s00246-020-02435-7
Silini A, Avesani M, Houyel L, et al. The pivotal role of tricuspid regurgitation in the failing systemic right ventricle: the “chicken and egg story”. Arch Cardiovasc Dis 2022;115:476-86.
DOI: https://doi.org/10.1016/j.acvd.2022.05.004
Muraru D, Badano LP, Hahn RT, et al. Atrial secondary tricuspid regurgitation: pathophysiology, definition, diagnosis, and treatment. Eur Heart J 2024;45:895-911.
DOI: https://doi.org/10.1093/eurheartj/ehae088
Marelli AJ, Ionescu-Ittu R, Mackie AS, et al. Lifetime prevalence of congenital heart disease in the general population from 2000 to 2010. Circulation 2014;130:749-56.
DOI: https://doi.org/10.1161/CIRCULATIONAHA.113.008396
How to Cite
Pozza, Alice, Martina Avesani, Irene Cattapan, Elena Reffo, Annachiara Cavaliere, Jolanda Sabatino, Sofia Piana, et al. 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 94 (3). https://doi.org/10.4081/monaldi.2024.3085.
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Elio Gorga, Marta Scodro, Francesca Valentini, Renzo D'Ortona, Mariachiara Arisi, Edoardo Sciatti, Ivano Bonadei, Valentina Regazzoni, Enrico Vizzardi, Marco Metra, Piergiacomo Calzavara Pinton, Echocardiographic evaluation of diastolic dysfunction in young and healthy patients with psoriasis: A case-control study , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- Francesco Giallauria, Lucrezia Piccioli, Giuseppe Vitale, Filippo M. Sarullo, Exercise training in patients with chronic heart failure: A new challenge for Cardiac Rehabilitation Community , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- A. Brunelli, C. Pompili, M. Salati, Low-technology exercise test in the preoperative evaluation of lung resection candidates , Monaldi Archives for Chest Disease: Vol. 73 No. 2 (2010): Pulmonary series
- Sotirios D. Moraitis, Apostolos C. Agrafiotis, Dimitrios Pappas, Chrysovalantis Pothitakis, Maria Stergianni, Ioannis Koukis, Thymic pathology and cardiac myxomas: Coincidence or a closer relationship? , Monaldi Archives for Chest Disease: Vol. 88 No. 1 (2018)
- Francesco Giallauria, Marco Gentile, Paolo Chiodini, Franco Berrino, Amalia Mattiello, Luigi Maresca, Alessandra Vitelli, Maria Mancini, Alessandra Grieco, Angelo Russo, Rosa Lucci, Giorgio Torella, Salvatore Panico, Carlo Vigorito, Exercise training reduces high mobility group box-1 protein levels in women with breast cancer: findings from the DIANA-5 study , Monaldi Archives for Chest Disease: Vol. 82 No. 2 (2014): Cardiac series
- Roberto F.E. Pedretti, Francesco Fattirolli, Raffaele Griffo, Marco Ambrosetti, Elisabetta Angelino, Silvia Brazzo, Ugo Corrà , Nicolò Dasseni, Pompilio Faggiano, Giuseppe Favretto, Oreste Febo, Marina Ferrari, Francesco Giallauria, Cesare Greco, Manuela Iannucci, Maria Teresa La Rovere, Mario Mallardo, Antonio Mazza, Massimo Piepoli, Carmine Riccio, Simonetta Scalvini, Luigi Tavazzi, Pier Luigi Temporelli, Gian Francesco Mureddu, Cardiac Prevention and Rehabilitation “3.0â€: From acute to chronic phase. Position Paper of the ltalian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR) , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- Ugo Corrà , Massimo F. Piepoli, Summary Statement on Cardiopulmonary Exercise Testing in Chronic Heart Failure due to Left Ventricular Dysfunction Recommendations for Performance and Interpretation , Monaldi Archives for Chest Disease: Vol. 68 No. 1 (2007): Cardiac series
- Domenico Galzerano, Claudio Pragliola, Mohamed Al Admawi, Mario Mallardo, Sara Di Michele, Carlo Gaudio, The role of 3D echocardiographic imaging in the differential diagnosis of an atypical left atrial myxoma , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- Concezione Tommasino, Cardiovascular risk assessment in the senior population undergoing anesthesia for non-cardiac surgery , Monaldi Archives for Chest Disease: Vol. 87 No. 2 (2017)
- Giuseppe Calsamiglia, Federica Camera, Antonio Mazza, Paola Villa, Francesca Gigli Berzolari, Roberto Tramarin, Franco Cobelli, A new test (VITTORIO Test) for functional fitness assessment in rehabilitation after cardiac surgery , Monaldi Archives for Chest Disease: Vol. 64 No. 1 (2005): Cardiac series
You may also start an advanced similarity search for this article.
