PMID- 33851400
OWN - NLM
STAT- MEDLINE
DCOM- 20210817
LR  - 20210817
IS  - 1439-1902 (Electronic)
IS  - 0171-6425 (Print)
IS  - 0171-6425 (Linking)
VI  - 69
IP  - S 03
DP  - 2021 Dec
TI  - A Comprehensive Functional Analysis in Patients after Atrial Switch Surgery.
PG  - e32-e40
LID - 10.1055/s-0041-1726307 [doi]
AB  - BACKGROUND: Long-term course after atrial switch operation is determined by 
      increasing right ventricular (RV) insufficiency. The aim of our study was to 
      investigate subtle functional parameters by invasive measurements with 
      conductance technique and noninvasive examinations with cardiac magnetic 
      resonance imaging (CMR). METHODS: We used invasive (pressure-volume loops under 
      baseline conditions and dobutamine) and noninvasive techniques (CMR with feature 
      tracking [FT] method) to evaluate RV function. All patients had cardiopulmonary 
      exercise testing (CPET). RESULTS: From 2011 to 2013, 16 patients aged 28.2 +/- 7.3 
      (22-50) years after atrial switch surgery (87.5% Senning and 12.5% Mustard) were 
      enrolled in this prospective study. All patients were in New York Heart 
      Association (NYHA) class I to II and presented mean peak oxygen consumption of 
      30.1 +/- 5.7 (22.7-45.5) mL/kg/min. CMR-derived end-diastolic volume was 110 +/- 22 
      (78-156) mL/m(2) and RV ejection fraction 41 +/- 8% (25-52%). CMR-FT revealed lower 
      global systolic longitudinal, radial, and circumferential strain for the systemic 
      RV compared with the subpulmonary left ventricle. End-systolic elastance (Ees) 
      was overall reduced (compared with data from the literature) and showed 
      significant increase under dobutamine (0.80 +/- 0.44 to 1.89 +/- 0.72 mm Hg/mL, p </= 
      0.001), whereas end-diastolic elastance (Eed) was not significantly influenced 
      (0.11 +/- 0.70 to 0.13 +/- 0.15 mm Hg/mL, p = 0.454). We found no relevant 
      relationship between load-independent conductance indices and strain or CPET 
      parameters. Conductance analysis revealed significant mechanical dyssynchrony, 
      higher during diastole (mean 30 +/- 4% baseline, 24 +/- 6% dobutamine) than during 
      systole (mean 17 +/- 6% baseline, 19 +/- 7% dobutamine). CONCLUSIONS: Functional 
      assessment of a deteriorating systemic RV remains demanding. Conductance indices 
      as well as the CMR-derived strain parameters showed overall reduced values, but a 
      significant relationship was not present (including CPET). Our conductance 
      analysis revealed intraventricular and predominantly diastolic RV dyssynchrony.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Hornung, Andreas
AU  - Hornung A
AD  - Department Pediatric Cardiology, Pulmonology and Intensive Care, University 
      Children's Hospital Tuebingen, Tuebingen, Germany.
FAU - Vollmer, Daniela
AU  - Vollmer D
AD  - Department Pediatric Cardiology, Pulmonology and Intensive Care, University 
      Children's Hospital Tuebingen, Tuebingen, Germany.
FAU - Wiegand, Gesa
AU  - Wiegand G
AD  - Department Pediatric Cardiology, Pulmonology and Intensive Care, University 
      Children's Hospital Tuebingen, Tuebingen, Germany.
FAU - Apitz, Christian
AU  - Apitz C
AD  - Department Pediatric Cardiology, University Children's Hospital Ulm, Ulm, 
      Germany.
FAU - Latus, Heiner
AU  - Latus H
AD  - Department Pediatric Cardiology and Congenital Heart Disease, German Heart 
      Center, Munich, Germany.
FAU - Hofbeck, Michael
AU  - Hofbeck M
AD  - Department Pediatric Cardiology, Pulmonology and Intensive Care, University 
      Children's Hospital Tuebingen, Tuebingen, Germany.
FAU - Sieverding, Ludger
AU  - Sieverding L
AD  - Department Pediatric Cardiology, Pulmonology and Intensive Care, University 
      Children's Hospital Tuebingen, Tuebingen, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210413
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
SB  - IM
MH  - Adult
MH  - Arterial Switch Operation/*adverse effects
MH  - *Cardiac Catheterization
MH  - Cross-Sectional Studies
MH  - Exercise Test
MH  - Female
MH  - Humans
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Time Factors
MH  - Transposition of Great Vessels/*surgery
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Right/*diagnosis/etiology/physiopathology
MH  - *Ventricular Function, Right
MH  - *Ventricular Pressure
MH  - Young Adult
PMC - PMC8045928
COIS- On behalf of all authors, the corresponding author states that there is no 
      conflict of interest.
EDAT- 2021/04/15 06:00
MHDA- 2021/08/18 06:00
PMCR- 2021/04/14
CRDT- 2021/04/14 06:45
PHST- 2021/04/14 06:45 [entrez]
PHST- 2021/04/15 06:00 [pubmed]
PHST- 2021/08/18 06:00 [medline]
PHST- 2021/04/14 00:00 [pmc-release]
AID - 205910pcc [pii]
AID - 10.1055/s-0041-1726307 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2021 Dec;69(S 03):e32-e40. doi: 10.1055/s-0041-1726307. 
      Epub 2021 Apr 13.