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Updated: Feb 28, 2026

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Left ventricular outflow tract obstruction and its impact on systolic ventricular function and exercise capacity in
Annina Stauber1, Céline Wey1, Matthias Greutmann2
1Department of Cardiology, Inselspital, University Hospital, University of Bern, Switzerland.
Background:
In biventricular hearts the filling and contractility of one ventricle affects the performance of the other. In this study, we compared right ventricular systolic function and exercise capacity in patients with a subaortic right ventricle (RV) in relation to the presence of a left ventricular outflow tract obstruction (LVOTO).
Methods:
Retrospective chart review of adults with congenitally corrected transposition of the great arteries (ccTGA) or with a previous atrial switch procedure for complete TGA (D-TGA). A LVOTO was defined by a peak instantaneous systolic gradient>20mmHg. Right and left ventricular ejection fraction (EF) were measured by cardiac magnetic resonance imaging (CMR), and exercise capacity as the predicted peak oxygen consumption (peak VO2) on a cycle ergometer.
Results:
We identified 79 clinically stable adults (age 33±10years, 70% male). Nine patients (11%) had cc-TGA and 70 patients had (89%) D-TGA. Thirteen patients (16%) had a LVOTO with a mean peak instantaneous systolic gradient of 43±22mmHg. Patients with a LVOTO had higher left (68±7% vs. 60±9%, p=0.01) and right ventricular EF (52±8 vs. 46±9%, p=0.05) by CMR compared to patients without LVOTO. In a multivariate regression analysis with left ventricular EF and LVOTO as predictors, only left ventricular EF was independently associated with right ventricular EF (correlation coefficient 0.41, p<0.01). The presence of a LVOTO was not associated with improved exercise capacity.
Conclusions:
In adults with a subaortic RV, a pressure loaded subpulmonary left ventricle has a beneficial effect on systemic right ventricular EF.
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