PMID- 25948241
OWN - NLM
STAT- MEDLINE
DCOM- 20150624
LR  - 20220518
IS  - 1942-0080 (Electronic)
IS  - 1941-9651 (Linking)
VI  - 8
IP  - 5
DP  - 2015 May
TI  - Systemic right ventricular fibrosis detected by cardiovascular magnetic resonance 
      is associated with clinical outcome, mainly new-onset atrial arrhythmia, in 
      patients after atrial redirection surgery for transposition of the great 
      arteries.
LID - e002628 [pii]
LID - 10.1161/CIRCIMAGING.114.002628 [doi]
AB  - BACKGROUND: We hypothesized that fibrosis detected by late gadolinium enhancement 
      (LGE) cardiovascular magnetic resonance predicts outcomes in patients with 
      transposition of the great arteries post atrial redirection surgery. These 
      patients have a systemic right ventricle (RV) and are at risk of arrhythmia, 
      premature RV failure, and sudden death. METHODS AND RESULTS: Fifty-five patients 
      (aged 27+/-7 years) underwent LGE cardiovascular magnetic resonance and were 
      followed for a median 7.8 (interquartile range, 3.8-9.6) years in a prospective 
      single-center cohort study. RV LGE was present in 31 (56%) patients. The 
      prespecified composite clinical end point comprised new-onset sustained 
      tachyarrhythmia (atrial/ventricular) or decompensated heart failure 
      admission/transplantation/death. Univariate predictors of the composite end point 
      (n=22 patients; 19 atrial/2 ventricular tachyarrhythmia, 1 death) included RV LGE 
      presence and extent, RV volumes/mass/ejection fraction, right atrial area, peak 
      Vo(2), and age at repair. In bivariate analysis, RV LGE presence was 
      independently associated with the composite end point (hazard ratio, 4.95 [95% 
      confidence interval, 1.60-15.28]; P=0.005), and only percent predicted peak Vo(2) 
      remained significantly associated with cardiac events after controlling for RV 
      LGE (hazard ratio, 0.80 [95% confidence interval, 0.68-0.95]; P=0.009/5%). In 8 
      of 9 patients with >1 event, atrial tachyarrhythmia, itself a known risk factor 
      for mortality, occurred first. There was agreement between location and extent of 
      RV LGE at in vivo cardiovascular magnetic resonance and histologically documented 
      focal RV fibrosis in an explanted heart. There was RV LGE progression in a 
      different case restudied for clinical indications. CONCLUSIONS: Systemic RV LGE 
      is strongly associated with adverse clinical outcome especially arrhythmia in 
      transposition of the great arteries, thus LGE cardiovascular magnetic resonance 
      should be incorporated in risk stratification of these patients.
CI  - (c) 2015 American Heart Association, Inc.
FAU - Rydman, Riikka
AU  - Rydman R
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.).
FAU - Gatzoulis, Michael A
AU  - Gatzoulis MA
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.).
FAU - Ho, Siew Yen
AU  - Ho SY
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.).
FAU - Ernst, Sabine
AU  - Ernst S
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.).
FAU - Swan, Lorna
AU  - Swan L
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.).
FAU - Li, Wei
AU  - Li W
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.).
FAU - Wong, Tom
AU  - Wong T
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.).
FAU - Sheppard, Mary
AU  - Sheppard M
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.).
FAU - McCarthy, Karen P
AU  - McCarthy KP
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.).
FAU - Roughton, Michael
AU  - Roughton M
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.).
FAU - Kilner, Philip J
AU  - Kilner PJ
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.).
FAU - Pennell, Dudley J
AU  - Pennell DJ
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.).
FAU - Babu-Narayan, Sonya V
AU  - Babu-Narayan SV
AD  - From the NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital 
      (R.R., M.A.G., S.Y.H., S.E., L.S., W.L., T.W., M.S., K.P.M., P.J.K., D.J.P., 
      S.V.B.-N.), National Heart and Lung Institute (M.A.G., S.Y.H., S.E., L.S., W.L., 
      T.W., M.S., K.P.M., P.J.K., M.R., D.J.P., S.V.B.-N.), Royal Brompton Hospital, 
      Imperial College London, London, United Kingdom; and Section of Clinical 
      Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, 
      Stockholm, Sweden (R.R.). dj.pennell@rbht.nhs.uk.
LA  - eng
GR  - FS/11/38/28864/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Circ Cardiovasc Imaging
JT  - Circulation. Cardiovascular imaging
JID - 101479935
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Adult
MH  - Contrast Media
MH  - Electrocardiography
MH  - Endomyocardial Fibrosis/*diagnosis/*etiology
MH  - Exercise Test
MH  - Female
MH  - Gadolinium
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Prospective Studies
MH  - Survival Rate
MH  - Transposition of Great Vessels/*complications/surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - arrhythmias, cardiac
OT  - fibrosis
OT  - magnetic resonance imaging
OT  - prognosis
OT  - transposition of great vessels
EDAT- 2015/05/08 06:00
MHDA- 2015/06/25 06:00
CRDT- 2015/05/08 06:00
PHST- 2015/05/08 06:00 [entrez]
PHST- 2015/05/08 06:00 [pubmed]
PHST- 2015/06/25 06:00 [medline]
AID - CIRCIMAGING.114.002628 [pii]
AID - 10.1161/CIRCIMAGING.114.002628 [doi]
PST - ppublish
SO  - Circ Cardiovasc Imaging. 2015 May;8(5):e002628. doi: 
      10.1161/CIRCIMAGING.114.002628.