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Article: Mechanical Right Ventricular Dyssynchrony in Patients After Atrial Switch Operation for Transposition of the Great Arteries

TitleMechanical Right Ventricular Dyssynchrony in Patients After Atrial Switch Operation for Transposition of the Great Arteries
Authors
Issue Date2008
PublisherExcerpta Medica, Inc.. The Journal's web site is located at http://www.ajconline.org/
Citation
American Journal Of Cardiology, 2008, v. 101 n. 6, p. 874-881 How to Cite?
AbstractRecent data suggest potential benefits of cardiac resynchronization therapy in the management of right ventricular (RV) dysfunction in congenital heart disease. The aim of this study was to determine the nature, prevalence, and functional implications of mechanical RV dyssynchrony in patients after Senning or Mustard procedures for transposition of the great arteries. Twenty-eight patients (mean age 21.1 ± 3.5 years) at 19.9 ± 3.2 years after atrial switch operations and 29 healthy controls were studied. The times from the onset of QRS to peak systolic strain (Tε) at the base of and the mid RV free wall, the ventricular septum (VS), and the left ventricular (LV) free wall were determined using tissue Doppler echocardiography. Intraventricular mechanical delay was defined as ΔTε RV-VS and interventricular mechanical delay as ΔTε RV-LV. In patients, the magnitude of RV intra- and interventricular mechanical delay was correlated with cardiac magnetic resonance-derived RV volumes and ejection fractions (n = 26) and treadmill exercise testing parameters (n = 20). Compared with controls, patients had significantly longer ΔTε RV-VS (48.1 ± 50.9 vs 17.0 ± 16.1 ms, p <0.001) and ΔTε RV-LV (63.1 ± 49.5 vs 19.0 ± 12.9, p <0.001). Nine patients (32%) exhibited RV dyssynchrony (ΔTε RV-VS >49 ms, control mean ± 2SD), and 16 patients (57%) showed interventricular dyssynchrony (ΔTε RV-LV >45ms). In patients, RV intra- and interventricular mechanical delay was correlated negatively with the RV ejection fraction (both r = -0.42, p = 0.03) and percentage predicted maximum oxygen consumption (r = -0.50, p = 0.03, and r = -0.52, p = 0.02, respectively) and positively with minute ventilation/carbon dioxide production slope (r = 0.49, p = 0.03, and r = 0.56, p = 0.01, respectively). In conclusion, RV dyssynchrony is common in young adults after atrial switch operations and is associated with RV systolic dysfunction and impaired exercise performance. © 2008 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/170391
ISSN
2015 Impact Factor: 3.154
2015 SCImago Journal Rankings: 2.063
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChow, PCen_US
dc.contributor.authorLiang, XCen_US
dc.contributor.authorLam, WWMen_US
dc.contributor.authorCheung, EWYen_US
dc.contributor.authorWong, KTen_US
dc.contributor.authorCheung, YFen_US
dc.date.accessioned2012-10-30T06:07:58Z-
dc.date.available2012-10-30T06:07:58Z-
dc.date.issued2008en_US
dc.identifier.citationAmerican Journal Of Cardiology, 2008, v. 101 n. 6, p. 874-881en_US
dc.identifier.issn0002-9149en_US
dc.identifier.urihttp://hdl.handle.net/10722/170391-
dc.description.abstractRecent data suggest potential benefits of cardiac resynchronization therapy in the management of right ventricular (RV) dysfunction in congenital heart disease. The aim of this study was to determine the nature, prevalence, and functional implications of mechanical RV dyssynchrony in patients after Senning or Mustard procedures for transposition of the great arteries. Twenty-eight patients (mean age 21.1 ± 3.5 years) at 19.9 ± 3.2 years after atrial switch operations and 29 healthy controls were studied. The times from the onset of QRS to peak systolic strain (Tε) at the base of and the mid RV free wall, the ventricular septum (VS), and the left ventricular (LV) free wall were determined using tissue Doppler echocardiography. Intraventricular mechanical delay was defined as ΔTε RV-VS and interventricular mechanical delay as ΔTε RV-LV. In patients, the magnitude of RV intra- and interventricular mechanical delay was correlated with cardiac magnetic resonance-derived RV volumes and ejection fractions (n = 26) and treadmill exercise testing parameters (n = 20). Compared with controls, patients had significantly longer ΔTε RV-VS (48.1 ± 50.9 vs 17.0 ± 16.1 ms, p <0.001) and ΔTε RV-LV (63.1 ± 49.5 vs 19.0 ± 12.9, p <0.001). Nine patients (32%) exhibited RV dyssynchrony (ΔTε RV-VS >49 ms, control mean ± 2SD), and 16 patients (57%) showed interventricular dyssynchrony (ΔTε RV-LV >45ms). In patients, RV intra- and interventricular mechanical delay was correlated negatively with the RV ejection fraction (both r = -0.42, p = 0.03) and percentage predicted maximum oxygen consumption (r = -0.50, p = 0.03, and r = -0.52, p = 0.02, respectively) and positively with minute ventilation/carbon dioxide production slope (r = 0.49, p = 0.03, and r = 0.56, p = 0.01, respectively). In conclusion, RV dyssynchrony is common in young adults after atrial switch operations and is associated with RV systolic dysfunction and impaired exercise performance. © 2008 Elsevier Inc. All rights reserved.en_US
dc.languageengen_US
dc.publisherExcerpta Medica, Inc.. The Journal's web site is located at http://www.ajconline.org/en_US
dc.relation.ispartofAmerican Journal of Cardiologyen_US
dc.subject.meshAdulten_US
dc.subject.meshCardiac Surgical Procedures - Adverse Effects - Methodsen_US
dc.subject.meshEchocardiography, Doppler, Coloren_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHeart Atria - Surgeryen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshMagnetic Resonance Imagingen_US
dc.subject.meshMaleen_US
dc.subject.meshMyocardial Contraction - Physiologyen_US
dc.subject.meshPrevalenceen_US
dc.subject.meshPrognosisen_US
dc.subject.meshStroke Volumeen_US
dc.subject.meshTransposition Of Great Vessels - Diagnosis - Physiopathology - Surgeryen_US
dc.subject.meshVentricular Dysfunction, Right - Epidemiology - Etiology - Physiopathologyen_US
dc.titleMechanical Right Ventricular Dyssynchrony in Patients After Atrial Switch Operation for Transposition of the Great Arteriesen_US
dc.typeArticleen_US
dc.identifier.emailCheung, YF:xfcheung@hku.hken_US
dc.identifier.authorityCheung, YF=rp00382en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.amjcard.2007.11.033en_US
dc.identifier.pmid18328857-
dc.identifier.scopuseid_2-s2.0-40049110575en_US
dc.identifier.hkuros141241-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-40049110575&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume101en_US
dc.identifier.issue6en_US
dc.identifier.spage874en_US
dc.identifier.epage881en_US
dc.identifier.isiWOS:000254024000025-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridChow, PC=23099233800en_US
dc.identifier.scopusauthoridLiang, XC=12803290200en_US
dc.identifier.scopusauthoridLam, WWM=35292558200en_US
dc.identifier.scopusauthoridCheung, EWY=9432819700en_US
dc.identifier.scopusauthoridWong, KT=9039171300en_US
dc.identifier.scopusauthoridCheung, YF=7202111067en_US
dc.identifier.citeulike10010725-

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