Ventricular and atrial function and deformation is largely preserved after arterial switch operation

Area of Science:

• Cardiology
• Pediatric Cardiology
• Cardiovascular Imaging

Background:

• Transposition of the great arteries (TGA) is a complex congenital heart defect.
• Arterial switch operation (ASO) is the standard surgical repair for TGA.
• Long-term effects of ASO on ventricular and atrial function require further investigation.

Purpose of the Study:

• To compare biventricular and biatrial function in patients with TGA after ASO versus healthy controls.
• To identify specific functional impairments in patients post-ASO.
• To evaluate the utility of cardiovascular magnetic resonance (CMR) and machine learning in assessing cardiac function.

Main Methods:

• A cohort of 103 patients with TGA post-ASO and 77 healthy controls were studied.
• Standard CMR techniques and feature tracking were used to assess biventricular and biatrial function.
• Non-parametric statistics and machine learning methods were employed for group comparison and identification of discriminative variables.

Main Results:

• Most markers of ventricular and atrial function were largely preserved in TGA patients compared to controls.
• Significant reductions were observed in left atrial longitudinal strain and right ventricular (RV) longitudinal function (TAPSE).
• A logistic regression model highlighted TAPSE and LA global longitudinal strain as key discriminators between groups.

Conclusions:

• Biventricular and biatrial function are generally well-preserved following ASO for TGA.
• Subtle but significant impairments in RV longitudinal function and LA function are detectable.
• Comprehensive CMR combined with advanced statistical analysis can identify specific functional deficits post-ASO.