title: Evaluation of Right Ventricular Myocardial Mechanics Using Velocity Vector Imaging of Cardiac MRI Cine Images in Transposition of the Great Arteries Following Atrial and Arterial Switch Operations.
abstract: OBJECTIVE
  The aim of the study was to determine right and left ventricle deformation parameters in patients with transposition of the great arteries who had undergone atrial or arterial switch procedures.
  
  
  METHODS
  Patients with transposition are born with a systemic right ventricle. Historically, the atrial switch operation, in which the right ventricle remains the systemic ventricle, was performed. These patients have increased rates of morbidity and mortality. We used cardiac MRI with Velocity Vector Imaging analysis to characterize and compare ventricular myocardial deformation in patients who had an atrial switch or arterial switch operation.
  
  
  METHODS
  Patients with a history of these procedures, who had a clinically ordered cardiac MRI were included in the study. Consecutive 20 patients (75% male, 28.7 ± 1.8 years) who underwent atrial switch operation and 20 patients (60% male, 17.7 ± 1.9 years) who underwent arterial switch operation were included in the study. Four chamber and short-axis cine images were used to determine longitudinal and circumferential strain and strain rate using Vector Velocity Imaging software.
  
  
  RESULTS
  Compared with the arterial switch group, the atrial switch group had decreased right ventricular ejection fraction and increased end-diastolic and end-systolic volumes, and no difference in left ventricular ejection fraction and volumes. The atrial switch group had decreased longitudinal and circumferential strain and strain rate. When compared with normal controls multiple strain parameters in the atrial switch group were reduced.
  
  
  CONCLUSIONS
  Myocardial deformation analysis of transposition patients reveals a reduction of right ventricular function and decreased longitudinal and circumferential strain parameters in patients with an atrial switch operation compared with those with arterial switch operation. A better understanding of the mechanisms of right ventricle failure in transposition of great arteries may lead to improved therapies and adaptation.
authors: Division of Pediatric Cardiology, Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
authors: Bijoy D
authors: BD
authors: Thattaliyath
authors: Division of Pediatric Cardiology, Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
authors: Daniel E
authors: DE
authors: Forsha
authors: Section of Cardiology, Department of Pediatrics, Children's Hospital Colorado, Aurora, Colo, USA.
authors: Chad
authors: C
authors: Stewart
authors: Division of Pediatric Cardiology, Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
authors: Piers C A
authors: PC
authors: Barker
authors: Division of Pediatric Cardiology, Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
authors: Michael J
authors: MJ
authors: Campbell
mesh_terms: D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D003971:Diastole; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012984:Software; D013318:Stroke Volume; D013599:Systole; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D055815:Young Adult
keywords: Arterial Switch Operation; Atrial Switch Operation; Cardiac Magnetic Resonance Imaging; Systemic Right Ventricle; Transposition of Great Vessels; Vector Velocity Imaging
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