title: Systemic right ventricles rarely show myocardial scars in cardiac magnetic resonance delayed-enhancement imaging.
abstract: OBJECTIVE
  To test the hypothesis that myocardial scars cause systolic dysfunction in patients with transposition of the great arteries and a systemic right ventricle.
  
  
  METHODS
  We retrospectively analyzed 20 consecutive patients (10 male, mean age 27.3 years) with a systemic right ventricle who underwent cardiac magnetic resonance imaging with 1.5 T. Cine steady-state free-precession sequences were performed to obtain volumes and function. Phase-sensitive inversion-recovery (PSIR) delayed-enhancement imaging was performed to detect myocardial scars. Tricuspid insufficiency was detected with echocardiography. Furthermore, the presence of arrhythmias and New York Heart Association (NYHA) class were assessed.
  
  
  RESULTS
  Mean ejection fraction of systemic right ventricles was 43 ± 11 %, mean end-diastolic volume index was 111 ± 37 ml/m(2). Delayed-enhancement imaging revealed only one myocardial scar in the wall of a right ventricular aneurysm. All patients but one (95 %) presented with tricuspid insufficiency. Clinically relevant arrhythmias were present in 13/20 patients (65 %). The majority of patients (90 %) were NYHA class I or II. Arrhythmias, tricuspid insufficiency and NYHA class were not associated with right ventricular ejection fraction.
  
  
  CONCLUSIONS
  Although right ventricular function was clearly impaired in our patient cohort, there was only one myocardial scar. Our results show that myocardial scarring assessed by PSIR delayed-enhancement imaging is not the underlying pathology of systemic right ventricular failure.
authors: University of Leipzig, Heart Center, Leipzig, Germany. uta.preim@googlemail.com
authors: Uta
authors: U
authors: Preim
authors: Janine
authors: J
authors: Hoffmann
authors: Lukas
authors: L
authors: Lehmkuhl
authors: Jana
authors: J
authors: Kehrmann
authors: Franziska
authors: F
authors: Riese
authors: Ingo
authors: I
authors: Daehnert
authors: Martin
authors: M
authors: Kostelka
authors: Matthias
authors: M
authors: Gutberlet
authors: Matthias
authors: M
authors: Grothoff
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D000080041:Congenitally Corrected Transposition of the Great Arteries; D003287:Contrast Media; D005260:Female; D006333:Heart Failure / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D006352:Heart Ventricles / Q000002:abnormalities* / Q000503:physiopathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D009206:Myocardium / Q000473:pathology*; D009942:Organometallic Compounds; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D014188:Transposition of Great Vessels / Q000150:complications* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D018497:Ventricular Dysfunction, Right / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D016278:Ventricular Function, Right; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol
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