ORIGINAL ARTICLE

Impaired atrioventricular transport in patients with transposition of the great arteries palliated by atrial switch and preserved systolic right ventricular function: A magnetic resonance imaging study

Corresponding Author

Magalie Ladouceur MD

[email protected]

orcid.org/0000-0002-4325-3521

INSERM U970, PARCC, Paris Descartes University, Paris, France

Department of Pediatric Cardiology, Complex Congenital Heart Disease Reference Center, M3C, Hôpital Necker Enfants malades, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

Correspondence Magalie Ladouceur, INSERM U970, PARCC, Paris Descartes University, 20 rue Leblanc, Paris 75015, France. Email: [email protected]Search for more papers by this author

Nadjia Kachenoura PhD,

Nadjia Kachenoura PhD

Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMR_S 1146, LIB, INSERM, UMR_S 1146, CNRS, UMR 7371, Paris, 75013 France

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Gilles Soulat MD,

Gilles Soulat MD

INSERM U970, PARCC, Paris Descartes University, Paris, France

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Emilie Bollache PhD,

Emilie Bollache PhD

Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMR_S 1146, LIB, INSERM, UMR_S 1146, CNRS, UMR 7371, Paris, 75013 France

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Alban Redheuil MD, PhD,

Alban Redheuil MD, PhD

Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMR_S 1146, LIB, INSERM, UMR_S 1146, CNRS, UMR 7371, Paris, 75013 France

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Michel Azizi MD, PhD,

Michel Azizi MD, PhD

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Christophe Delclaux MD, PhD,

Christophe Delclaux MD, PhD

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Gilles Chatellier MD, PhD,

Gilles Chatellier MD, PhD

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Pierre Boutouyrie MD, PhD,

Pierre Boutouyrie MD, PhD

INSERM U970, PARCC, Paris Descartes University, Paris, France

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Laurence Iserin MD,

Laurence Iserin MD

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Damien Bonnet MD, PhD,

Damien Bonnet MD, PhD

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Elie Mousseaux MD, PhD,

Elie Mousseaux MD, PhD

INSERM U970, PARCC, Paris Descartes University, Paris, France

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Magalie Ladouceur MD,

Corresponding Author

Magalie Ladouceur MD

[email protected]

orcid.org/0000-0002-4325-3521

INSERM U970, PARCC, Paris Descartes University, Paris, France

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

Correspondence Magalie Ladouceur, INSERM U970, PARCC, Paris Descartes University, 20 rue Leblanc, Paris 75015, France. Email: [email protected]Search for more papers by this author

Nadjia Kachenoura PhD,

Nadjia Kachenoura PhD

Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMR_S 1146, LIB, INSERM, UMR_S 1146, CNRS, UMR 7371, Paris, 75013 France

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Gilles Soulat MD,

Gilles Soulat MD

INSERM U970, PARCC, Paris Descartes University, Paris, France

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Emilie Bollache PhD,

Emilie Bollache PhD

Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMR_S 1146, LIB, INSERM, UMR_S 1146, CNRS, UMR 7371, Paris, 75013 France

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Alban Redheuil MD, PhD,

Alban Redheuil MD, PhD

Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMR_S 1146, LIB, INSERM, UMR_S 1146, CNRS, UMR 7371, Paris, 75013 France

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Michel Azizi MD, PhD,

Michel Azizi MD, PhD

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

Search for more papers by this author

Christophe Delclaux MD, PhD,

Christophe Delclaux MD, PhD

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

Search for more papers by this author

Gilles Chatellier MD, PhD,

Gilles Chatellier MD, PhD

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Pierre Boutouyrie MD, PhD,

Pierre Boutouyrie MD, PhD

INSERM U970, PARCC, Paris Descartes University, Paris, France

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Laurence Iserin MD,

Laurence Iserin MD

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Damien Bonnet MD, PhD,

Damien Bonnet MD, PhD

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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Elie Mousseaux MD, PhD,

Elie Mousseaux MD, PhD

INSERM U970, PARCC, Paris Descartes University, Paris, France

Georges Pompidou European Hospital, AP-HP, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France

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First published: 16 May 2017

https://doi.org/10.1111/chd.12472

Citations: 11

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Abstract

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, prospective study.

Setting

In patients with D-TGA palliated by atrial switch, diastolic dysfunction of the systemic right ventricle may precede systolic dysfunction.

Methods

Forty-five patients with D-TGA and atrial switch and 45 age and sex-matched healthy subjects underwent cardiac magnetic resonance imaging and echocardiography. Filling flow-rates measured by phase-contrast cardiac magnetic resonance imaging were analyzed using customized software to estimate diastolic parameters and compared with exercise performance.

Results

In D-TGA, early filling of systemic right ventricle was impaired with a lower peak filling rate normalized by filling volume (Ef/FV measured by cardiac magnetic resonance imaging) and a higher early filling peak velocity normalized by early peak myocardial velocity (E_US/Ea measured by echocardiography) compared with controls (P ≤ .04). Stroke volume of systemic right ventricle showed a direct and significant association with pulmonary venous pathway size (respectively r = 0.50, P < .01). Systemic right atrial area and systemic right ventricle mass/volume index measured by cardiac magnetic resonance imaging, as well as Ef/FV were significantly correlated with exercise performances and BNP (P < .01). All correlations were independent of age, gender, body mass index and blood pressure.

Conclusions

Systemic right ventricle pre-load and stroke volume depend mainly on intraatrial pathway function. Moreover, systemic right ventricle remodeling and right atrial dysfunction impair systemic right ventricle filling, leading to BNP increase and exercise limitation. Cardiac magnetic resonance imaging should assess systemic right ventricle filling abnormalities in D-TGA patients.

REFERENCES

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Citing Literature

Volume12, Issue4

July/August 2017

Pages 458-466

Impaired atrioventricular transport in patients with transposition of the great arteries palliated by atrial switch and preserved systolic right ventricular function: A magnetic resonance imaging study

Abstract

Objectives

Design

Setting

Methods

Results

Conclusions

REFERENCES

Citing Literature

References

Information

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Impaired atrioventricular transport in patients with transposition of the great arteries palliated by atrial switch and preserved systolic right ventricular function: A magnetic resonance imaging study

Abstract

Objectives

Design

Setting

Methods

Results

Conclusions

REFERENCES

Citing Literature

References

Related

Information