Relation of Systemic Ventricular Function Quantified by Myocardial Performance Index (Tei) to Cardiopulmonary Exercise Capacity in Adults After Mustard Procedure for Transposition of the Great Arteries

After Mustard repair for transposition of the great arteries, the right ventricle serves as a chronically overloaded systemic ventricle (SV). Thus, during long-term follow-up, dysfunction of the right ventricle with consecutive heart failure (HF) is not unusual. Early signs and symptoms of HF are depressed parameters of right ventricular (RV) function at rest and exercise intolerance. It was hypothesized that the measurement of RV function parameters, N-terminal pro–brain natriuretic peptide (NT–pro-BNP), and peak oxygen uptake (VO 2max) during exercise testing were suitable for the early detection of subclinical HF. In 33 asymptomatic adolescents and adults who had undergone Mustard repair, RV function was analyzed by the myocardial performance index (Tei index). NT–pro-BNP and VO 2max were also determined. The corresponding data from 52 patients operated on for left-to-right shunt defects without residual lesions served as reference data. In patients who underwent the Mustard procedue, the Tei index and NT–pro-BNP were elevated (mean Tei index of the SV 0.63 ± 0.17 vs 0.34 ± 0.05, p