Diastolic biventricular impairment at long-term follow-up after atrial switch operation for complete transposition of the great arteries: an exercise tissue Doppler echocardiography study.
OBJECTIVE
The aim of this study was to investigate regional myocardial function after atrial switch operation for transposition of the great arteries (TGA) using tissue Doppler echocardiography with strain rate (SR) imaging.


METHODS
In all, 24 patients with TGA aged 12 to 33 years and 10 control subjects underwent tissue Doppler echocardiography/SR imaging at rest and during bicycle exercise at 1 and 2 W/kg. Longitudinal function was quantified by strain, SR, and peak velocities measured in the free wall of the systemic ventricle, in septum and in the lateral wall of the subpulmonary ventricle.


RESULTS
In patients with TGA, both ventricles showed reduced peak systolic SR values at rest. The increase in peak early diastolic velocity with exercise was reduced in the systemic ventricle (-47 +/- 23 mm/s at rest to -73 +/- 35 mm/s at 2 W/kg, P < .05) and absent in the subpulmonary ventricle (-78 +/- 38 mm/s at rest to -75 +/- 19 mm/s at 2 W/kg) of patients with TGA.


CONCLUSIONS
Exercise tissue Doppler echocardiography/SR imaging identified severely reduced relaxation reserve of both ventricles as typical feature of myocardial dysfunction after atrial repair for TGA.
Poerner
Tudor C
TC
First Department of Medicine, University Hospital of Jena, Jena, Germany. tpoerner@googlemail.com
Goebel
Björn
B
Figulla
Hans R
HR
Ulmer
Herbert E
HE
Gorenflo
Matthias
M
Borggrefe
Martin
M
Arnold
Raoul
R
D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D015150:Echocardiography, Doppler / Q000379:methods*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D013318:Stroke Volume; D014188:Transposition of Great Vessels / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*