title: Tricuspid annular plane systolic excursion for the assessment of ventricular function in adults operated on with mustard procedure for complete transposition of the great arteries.
abstract: BACKGROUND
  In adult patients with d-transposition of the great arteries after atrial switch operation, dysfunction of the systemic right ventricle (RV) is a well-known complication. Echocardiographic variables may provide adequate estimation of subpulmonary RV function, but their applicability to the subaortic RV is not straightforward. We evaluate the concordance between tricuspid annular plane systolic excursion (TAPSE) and magnetic resonance imaging-derived ejection fraction of the RV (MRI-RVEF) in these patients.
  
  
  METHODS
  Patients were recruited from those evaluated at the adult congenital clinic of our department between 2010 and 2012. All patients who had an echocardiographic assessment within 6 months of their MRI examination were selected. Patients clinically unstable, not in sinus rhythm, with a prosthetic systemic atrioventricular valve, permanent pacemaker, or more than moderate systemic atrioventricular valve regurgitation were excluded.
  
  
  RESULTS
  Eighteen Mustard-operated patients aged 22 ± 3.7 years were studied. The mean values of TAPSE and RVEF were 13.22 ± 1.7 mm and 49.7 ± 6%, respectively. TAPSE and RVEF were normal in 1 (5.5%) and 10 (55.5%) patients, respectively. Seventeen (94.4%) patients showed reduced TAPSE (12.9 ± 1.3 mm): RVEF was reduced in eight (47%) of these subjects, and normal in nine (53%). In patients with normal RVEF, both the MRI-RV end-diastolic and the MRI-RV end-systolic volumes were significantly lower than in patients with reduced RVEF. There were no other statistically significant differences between these patients. No correlation was found between TAPSE and both the MRI-RV end-diastolic and the end-systolic volumes. Globally, agreement between TAPSE and RVEF was slight (K = 0.09 ± 0.089).
  
  
  CONCLUSIONS
  Our results indicate that in these patients TAPSE is not a useful measure of RV function.
authors.affiliation: Department of Cardiology, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: De Caro
authors.forename: Sara
authors.initials: S
authors.lastname: Bondanza
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Calevo
authors.forename: Gianluca
authors.initials: G
authors.lastname: Trocchio
authors.forename: Gabriele
authors.initials: G
authors.lastname: Lupi
authors.forename: Stefano
authors.initials: S
authors.lastname: Domenicucci
authors.forename: Maurizio
authors.initials: M
authors.lastname: Marasini
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D018618:Echocardiography, Doppler, Color; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013318:Stroke Volume; D014188:Transposition of Great Vessels / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016278:Ventricular Function, Right; D055815:Young Adult
keywords: Echocardiography; Magnetic Resonance-Derived Ejection Fraction of the Right Ventricle (MRI-RVEF); Mustard Procedure; Tricuspid Annular Plane Systolic Excursion (TAPSE); d-Transposition of the Great Arteries (d-TGA)