Subaortic right ventricular characteristics and relationship to exercise capacity in congenitally corrected

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Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
07:11

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography

Published on: October 28, 2020

Jasmine Grewal1, Andrew Crean, Patrick Garceau

  • 1Division of Cardiology, University of British Columbia Pacific Adult Congenital Heart Disease Clinic, St. Paul's Hospital, Vancouver, British Columbia, Canada. grewaljasmine@hotmail.com

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|September 18, 2012
PubMed

Insights

Congenitally corrected transposition of the great arteries (cc-TGA) often leads to systemic right ventricular (RV) dilation and dysfunction, impacting exercise capacity. Tricuspid regurgitation significantly contributes to these issues in cc-TGA patients.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Cardiac Imaging

Background:

  • Congenitally corrected transposition of the great arteries (cc-TGA) involves the right ventricle (RV) acting as the systemic ventricle.
  • Progressive RV deterioration is a known complication in cc-TGA.
  • Understanding factors contributing to RV dysfunction is crucial for patient management.

Purpose of the Study:

  • To characterize the systemic RV in adults with cc-TGA.
  • To identify factors associated with RV dilation and dysfunction.
  • To explore the relationship between RV function and exercise capacity.

Main Methods:

  • Prospective study of adult cc-TGA patients.
  • Cardiopulmonary stress testing for exercise capacity assessment.
  • Cardiac MRI for ventricular volume and fibrosis; Velocity Vector Imaging for strain echocardiography.

Main Results:

  • Reduced exercise capacity in cc-TGA patients compared to controls (20.9 vs 30.8 mL/kg/min).
  • Majority (61%) had RV ejection fraction ≤ 40%.
  • Significant differences in RV diastolic volumes and strain parameters observed, linked to tricuspid regurgitation severity.

Conclusions:

  • Systemic RV dilation, dysfunction, and exercise intolerance are common in cc-TGA.
  • Significant tricuspid regurgitation is a major contributor to RV problems.
  • Abnormal RV myocardial deformation suggests failure to adapt to systemic pressure; afterload-reducing therapies warrant investigation.
Abstract

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