title: Is systemic right ventricular function by cardiac MRI related to the degree of tricuspid regurgitation in congenitally corrected transposition of the great arteries?
abstract: METHODS
  Systemic right ventricular dysfunction and tricuspid regurgitation (TR) are frequently encountered in patients with congenitally corrected transposition of the great arteries (CCTGA). Studies using echocardiography have suggested a relationship between the degree of TR and systemic right ventricular dysfunction; however, assessment of systemic right ventricular function by echocardiography is limited. Cardiac MRI (CMR) is the gold standard for volumetric assessment of the systemic right ventricle. We performed a retrospective cohort study at our center evaluating all adult patients with CCTGA who underwent a CMR between 1/1999 and 1/2013 to determine the relationship between the degree of TR and systemic right ventricular function.
  
  
  RESULTS
  Of the 33 patients identified, 12 had ≤ mild TR (37%), 13 had moderate TR (40%), and 8 had severe TR (24%). Mean age at CMR was 38 years (23-64). Mean right ventricular ejection fraction (45% vs. 41% vs. 42%, p=0.68) and mean indexed right ventricular end diastolic volume (122 ml/m(2) vs. 136 ml/m(2) vs. 138 ml/m(2)p=0.36) were not significantly different for patients with ≤ mild TR, moderate TR or severe TR. The degree of TR was not associated with additional congenital lesions, prior procedures, presence of an intraventricular conduction delay, or decreased left ventricular function.
  
  
  CONCLUSIONS
  No association between the degree of TR and right ventricular volume or ejection fraction by CMR was identified. Failure to show worsening function or increased volume with greater degrees of TR suggests that the degree of regurgitation alone may not fully explain the heterogeneity in right ventricular size and function.
authors.affiliation: Division of Cardiology, Department of Medicine, Schneeweiss Adult Congenital Heart Center, Columbia University Medical Center, New York, NY, United States. Electronic address: ml3329@columbia.edu.
authors.forename: Matthew
authors.initials: M
authors.lastname: Lewis
authors.affiliation: Division of Cardiology, Department of Medicine, Schneeweiss Adult Congenital Heart Center, Columbia University Medical Center, New York, NY, United States.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ginns
authors.affiliation: Division of Cardiology, Department of Medicine, Schneeweiss Adult Congenital Heart Center, Columbia University Medical Center, New York, NY, United States.
authors.forename: Marlon
authors.initials: M
authors.lastname: Rosenbaum
mesh_terms: D000328:Adult; D015331:Cohort Studies; D000080041:Congenitally Corrected Transposition of the Great Arteries; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014188:Transposition of Great Vessels / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult
keywords: Cardiac MRI; Systemic right ventricle; Transposition of the great arteries; Tricuspid regurgitation