Systolic dysfunction of the subpulmonary left ventricle is associated with the severity of heart failure in patients with a systemic right ventricle
The study aimed to assess the relation between echocardiographic parameters of subpulmonary left ventricular (LV) size and function, and the severity of heart failure in patients with a systemic right ventricle (SRV). A total of 157 patients (89 post Mustard/Senning operations, 68 with congenitally...
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| Veröffentlicht in: | International journal of cardiology 2021-02, Vol.324, p.66-71 |
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| container_title | International journal of cardiology |
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| creator | Surkova, Elena Segura, Teresa Dimopoulos, Konstantinos Bispo, Daniela Flick, Caroline West, Cathy Babu-Narayan, Sonya V. Senior, Roxy Gatzoulis, Michael A. Li, Wei |
| description | The study aimed to assess the relation between echocardiographic parameters of subpulmonary left ventricular (LV) size and function, and the severity of heart failure in patients with a systemic right ventricle (SRV).
A total of 157 patients (89 post Mustard/Senning operations, 68 with congenitally corrected transposition of great arteries [ccTGA]) were included. The size and function of the SRV and subpulmonary LV were assessed on the most recent echocardiographic exam. Clinical data were collected from the electronic records.
The majority (133, 84.7%) were in NYHA functional class 1–2. Median BNP concentration was 79.5[38.3–173.3] ng/l, and 100 (63.7%) patients were receiving heart failure therapy. Both LV and SRV fractional area change (FAC) differed significantly between patients with NYHA class 1–2 vs 3–4 (48[41.5–52.8]% vs 34[28.6–38.6]%, p |
| doi_str_mv | 10.1016/j.ijcard.2020.09.051 |
| format | Article |
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A total of 157 patients (89 post Mustard/Senning operations, 68 with congenitally corrected transposition of great arteries [ccTGA]) were included. The size and function of the SRV and subpulmonary LV were assessed on the most recent echocardiographic exam. Clinical data were collected from the electronic records.
The majority (133, 84.7%) were in NYHA functional class 1–2. Median BNP concentration was 79.5[38.3–173.3] ng/l, and 100 (63.7%) patients were receiving heart failure therapy. Both LV and SRV fractional area change (FAC) differed significantly between patients with NYHA class 1–2 vs 3–4 (48[41.5–52.8]% vs 34[28.6–38.6]%, p < 0.0001 and 29.5[23–35]% vs 22[20–27]%, p < 0.0001, respectively), but LV FAC had a higher discriminative power for functional class >2 than SRV FAC (AUC 0.90, p < 0.0001 vs 0.79; p < 0.0001, respectively). A LV FAC cut-off value <39.2% had the highest accuracy in identifying patients with NYHA class 3–4 (sensitivity 83% and specificity 88%). In multivariable logistic regression analysis, LV FAC and SRV FAC independently associated to NYHA class 3–4 (OR 0.80 [95%CI 0.72–0.88], p < 0.0001 and OR 0.85 [95%CI 0.76–0.96], p = 0.007, respectively).
Subpulmonary LV systolic dysfunction is associated with NYHA functional class 3–4 in patients with ccTGA or after Mustard or Senning operation. Careful evaluation of the subpulmonary LV should be a part of the routine assessment of patients with a SRV.
•Dysfunction of subpulmonary left ventricle (LV) is independently associated with NYHA class 3–4;•LV fractional area change (FAC) is more accurate than systemic right ventricle FAC in predicting heart failure symptoms;•LV FAC rather than MAPSE provides a reasonably accurate echocardiographic quantification of subpulmonary LV;•subpulmonary LV function requires accurate assessment during routine follow up.]]></description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2020.09.051</identifier><identifier>PMID: 32987051</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Congenitally Corrected Transposition of the Great Arteries ; Echocardiography ; Heart failure ; Heart Failure - diagnostic imaging ; Heart Failure - epidemiology ; Heart Ventricles - diagnostic imaging ; Humans ; Subpulmonary left ventricle ; Systemic right ventricle ; Systolic function ; Transposition of Great Vessels - diagnostic imaging ; Transposition of Great Vessels - surgery</subject><ispartof>International journal of cardiology, 2021-02, Vol.324, p.66-71</ispartof><rights>2020 Elsevier B.V.</rights><rights>Copyright © 2020 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3231-64bb5a6753328c04fdc003b80f7949ef198ae3f07d76fdfaf495127f4c0e4c6b3</citedby><cites>FETCH-LOGICAL-c3231-64bb5a6753328c04fdc003b80f7949ef198ae3f07d76fdfaf495127f4c0e4c6b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijcard.2020.09.051$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32987051$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Surkova, Elena</creatorcontrib><creatorcontrib>Segura, Teresa</creatorcontrib><creatorcontrib>Dimopoulos, Konstantinos</creatorcontrib><creatorcontrib>Bispo, Daniela</creatorcontrib><creatorcontrib>Flick, Caroline</creatorcontrib><creatorcontrib>West, Cathy</creatorcontrib><creatorcontrib>Babu-Narayan, Sonya V.</creatorcontrib><creatorcontrib>Senior, Roxy</creatorcontrib><creatorcontrib>Gatzoulis, Michael A.</creatorcontrib><creatorcontrib>Li, Wei</creatorcontrib><title>Systolic dysfunction of the subpulmonary left ventricle is associated with the severity of heart failure in patients with a systemic right ventricle</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description><![CDATA[The study aimed to assess the relation between echocardiographic parameters of subpulmonary left ventricular (LV) size and function, and the severity of heart failure in patients with a systemic right ventricle (SRV).
A total of 157 patients (89 post Mustard/Senning operations, 68 with congenitally corrected transposition of great arteries [ccTGA]) were included. The size and function of the SRV and subpulmonary LV were assessed on the most recent echocardiographic exam. Clinical data were collected from the electronic records.
The majority (133, 84.7%) were in NYHA functional class 1–2. Median BNP concentration was 79.5[38.3–173.3] ng/l, and 100 (63.7%) patients were receiving heart failure therapy. Both LV and SRV fractional area change (FAC) differed significantly between patients with NYHA class 1–2 vs 3–4 (48[41.5–52.8]% vs 34[28.6–38.6]%, p < 0.0001 and 29.5[23–35]% vs 22[20–27]%, p < 0.0001, respectively), but LV FAC had a higher discriminative power for functional class >2 than SRV FAC (AUC 0.90, p < 0.0001 vs 0.79; p < 0.0001, respectively). A LV FAC cut-off value <39.2% had the highest accuracy in identifying patients with NYHA class 3–4 (sensitivity 83% and specificity 88%). In multivariable logistic regression analysis, LV FAC and SRV FAC independently associated to NYHA class 3–4 (OR 0.80 [95%CI 0.72–0.88], p < 0.0001 and OR 0.85 [95%CI 0.76–0.96], p = 0.007, respectively).
Subpulmonary LV systolic dysfunction is associated with NYHA functional class 3–4 in patients with ccTGA or after Mustard or Senning operation. Careful evaluation of the subpulmonary LV should be a part of the routine assessment of patients with a SRV.
•Dysfunction of subpulmonary left ventricle (LV) is independently associated with NYHA class 3–4;•LV fractional area change (FAC) is more accurate than systemic right ventricle FAC in predicting heart failure symptoms;•LV FAC rather than MAPSE provides a reasonably accurate echocardiographic quantification of subpulmonary LV;•subpulmonary LV function requires accurate assessment during routine follow up.]]></description><subject>Congenitally Corrected Transposition of the Great Arteries</subject><subject>Echocardiography</subject><subject>Heart failure</subject><subject>Heart Failure - diagnostic imaging</subject><subject>Heart Failure - epidemiology</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Humans</subject><subject>Subpulmonary left ventricle</subject><subject>Systemic right ventricle</subject><subject>Systolic function</subject><subject>Transposition of Great Vessels - diagnostic imaging</subject><subject>Transposition of Great Vessels - surgery</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcGO1DAQRC0EYmcX_gAhH7kktGMnTi5IaLXASitxAM6WY7cZj5J4sJ1B8x98MB5lQZw49eVVlbqKkFcMagase3uo_cHoaOsGGqhhqKFlT8iO9VJUTLbiKdkVTFZtI_kVuU7pAABiGPrn5Io3Qy8LvyO_vpxTDpM31J6TWxeTfVhocDTvkaZ1PK7THBYdz3RCl-kJlxy9mZD6RHVKwXid0dKfPu83CZ4w-ny-WOxRx0yd9tMai2ChR519MUgbrmkq2TiX7Oi_7_8xf0GeOT0lfPl4b8i3D3dfbz9VD58_3t--f6gMbzirOjGOre5ky3nTGxDOGgA-9uDkIAZ0bOg1cgfSys5Zp50YWtZIJwygMN3Ib8ibzfcYw48VU1azTwanSS8Y1qQaISRnLXSioGJDTQwpRXTqGP1celEM1GUPdVDbHuqyh4JBlX6L7PVjwjrOaP-K_gxQgHcbgOXPk8eokikdGbQ-osnKBv__hN9guqGx</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Surkova, Elena</creator><creator>Segura, Teresa</creator><creator>Dimopoulos, Konstantinos</creator><creator>Bispo, Daniela</creator><creator>Flick, Caroline</creator><creator>West, Cathy</creator><creator>Babu-Narayan, Sonya V.</creator><creator>Senior, Roxy</creator><creator>Gatzoulis, Michael A.</creator><creator>Li, Wei</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20210201</creationdate><title>Systolic dysfunction of the subpulmonary left ventricle is associated with the severity of heart failure in patients with a systemic right ventricle</title><author>Surkova, Elena ; Segura, Teresa ; Dimopoulos, Konstantinos ; Bispo, Daniela ; Flick, Caroline ; West, Cathy ; Babu-Narayan, Sonya V. ; Senior, Roxy ; Gatzoulis, Michael A. ; Li, Wei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3231-64bb5a6753328c04fdc003b80f7949ef198ae3f07d76fdfaf495127f4c0e4c6b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Congenitally Corrected Transposition of the Great Arteries</topic><topic>Echocardiography</topic><topic>Heart failure</topic><topic>Heart Failure - diagnostic imaging</topic><topic>Heart Failure - epidemiology</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Humans</topic><topic>Subpulmonary left ventricle</topic><topic>Systemic right ventricle</topic><topic>Systolic function</topic><topic>Transposition of Great Vessels - diagnostic imaging</topic><topic>Transposition of Great Vessels - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Surkova, Elena</creatorcontrib><creatorcontrib>Segura, Teresa</creatorcontrib><creatorcontrib>Dimopoulos, Konstantinos</creatorcontrib><creatorcontrib>Bispo, Daniela</creatorcontrib><creatorcontrib>Flick, Caroline</creatorcontrib><creatorcontrib>West, Cathy</creatorcontrib><creatorcontrib>Babu-Narayan, Sonya V.</creatorcontrib><creatorcontrib>Senior, Roxy</creatorcontrib><creatorcontrib>Gatzoulis, Michael A.</creatorcontrib><creatorcontrib>Li, Wei</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Surkova, Elena</au><au>Segura, Teresa</au><au>Dimopoulos, Konstantinos</au><au>Bispo, Daniela</au><au>Flick, Caroline</au><au>West, Cathy</au><au>Babu-Narayan, Sonya V.</au><au>Senior, Roxy</au><au>Gatzoulis, Michael A.</au><au>Li, Wei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systolic dysfunction of the subpulmonary left ventricle is associated with the severity of heart failure in patients with a systemic right ventricle</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>324</volume><spage>66</spage><epage>71</epage><pages>66-71</pages><issn>0167-5273</issn><eissn>1874-1754</eissn><abstract><![CDATA[The study aimed to assess the relation between echocardiographic parameters of subpulmonary left ventricular (LV) size and function, and the severity of heart failure in patients with a systemic right ventricle (SRV).
A total of 157 patients (89 post Mustard/Senning operations, 68 with congenitally corrected transposition of great arteries [ccTGA]) were included. The size and function of the SRV and subpulmonary LV were assessed on the most recent echocardiographic exam. Clinical data were collected from the electronic records.
The majority (133, 84.7%) were in NYHA functional class 1–2. Median BNP concentration was 79.5[38.3–173.3] ng/l, and 100 (63.7%) patients were receiving heart failure therapy. Both LV and SRV fractional area change (FAC) differed significantly between patients with NYHA class 1–2 vs 3–4 (48[41.5–52.8]% vs 34[28.6–38.6]%, p < 0.0001 and 29.5[23–35]% vs 22[20–27]%, p < 0.0001, respectively), but LV FAC had a higher discriminative power for functional class >2 than SRV FAC (AUC 0.90, p < 0.0001 vs 0.79; p < 0.0001, respectively). A LV FAC cut-off value <39.2% had the highest accuracy in identifying patients with NYHA class 3–4 (sensitivity 83% and specificity 88%). In multivariable logistic regression analysis, LV FAC and SRV FAC independently associated to NYHA class 3–4 (OR 0.80 [95%CI 0.72–0.88], p < 0.0001 and OR 0.85 [95%CI 0.76–0.96], p = 0.007, respectively).
Subpulmonary LV systolic dysfunction is associated with NYHA functional class 3–4 in patients with ccTGA or after Mustard or Senning operation. Careful evaluation of the subpulmonary LV should be a part of the routine assessment of patients with a SRV.
•Dysfunction of subpulmonary left ventricle (LV) is independently associated with NYHA class 3–4;•LV fractional area change (FAC) is more accurate than systemic right ventricle FAC in predicting heart failure symptoms;•LV FAC rather than MAPSE provides a reasonably accurate echocardiographic quantification of subpulmonary LV;•subpulmonary LV function requires accurate assessment during routine follow up.]]></abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>32987051</pmid><doi>10.1016/j.ijcard.2020.09.051</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Congenitally Corrected Transposition of the Great Arteries Echocardiography Heart failure Heart Failure - diagnostic imaging Heart Failure - epidemiology Heart Ventricles - diagnostic imaging Humans Subpulmonary left ventricle Systemic right ventricle Systolic function Transposition of Great Vessels - diagnostic imaging Transposition of Great Vessels - surgery |
| title | Systolic dysfunction of the subpulmonary left ventricle is associated with the severity of heart failure in patients with a systemic right ventricle |
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