The Sub-Pulmonary Left Ventricle in Patients with Systemic Right Ventricle, the Paradoxical Neglected Chamber: A Cardiac Magnetic Resonance Feature Tracking Study

: The impact of subpulmonary left ventricle (LV) dysfunction in patients with a systemic right ventricle (SRV) is insufficiently characterized, with only a few studies suggesting its prognostic significance. Additionally, its evaluation through imaging techniques is a challenge. To assess the correl...

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Veröffentlicht in:Journal of clinical medicine 2024-10, Vol.13 (20), p.6033
Hauptverfasser: Piana, Sofia, Pozza, Alice, Cavaliere, Annachiara, Molinaroli, Anna, Cattapan, Irene, Fumanelli, Jennifer, Avesani, Martina, Reffo, Elena, Di Salvo, Giovanni
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Sprache:eng
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Zusammenfassung:: The impact of subpulmonary left ventricle (LV) dysfunction in patients with a systemic right ventricle (SRV) is insufficiently characterized, with only a few studies suggesting its prognostic significance. Additionally, its evaluation through imaging techniques is a challenge. To assess the correlation between quantitative cardiac magnetic resonance-feature tracking (CMR-FT) data and the risk of clinical events related to the natural history of SRV failure. : In this cross-sectional study, 21 patients with a diagnosis of transposition of the great arteries (TGA) and atrial switch operation (AtSO) or congenitally corrected transposition (ccTGA) were recruited. All participants underwent CMR-FT analysis. Considered clinical events included NYHA class deterioration (from I-II to III-IV), increased diuretic therapy, arrhythmias, sudden cardiac death, and hospitalizations. : The cohort consisted of 52.4% males (mean age: 25.4 ± 11.9 years). Eleven patients were diagnosed with ccTGA. Of the 10 patients with TGA post-AtSO, 50% had undergone Mustard repair. Clinical events occurred in 11 patients, with 47.6% experiencing hospitalizations and 28.6% developing arrhythmias. Left ventricular global longitudinal strain (LV GLS) was significantly associated with event-risk in both univariate and multivariate analyses ( = 0.011; = 0.025). A cut-off value of LV GLS > -19.24 was proposed to stratify high-risk patients ( = 0.001). : Our study confirms the role of subpulmonary LV function in determining outcomes of SRV patients. The assessment of LV GLS by using CMR-FT could significantly enhance clinical management during follow-up.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13206033