Global longitudinal strain may identify preserved systolic function of the systemic right ventricle.
BACKGROUND
Assessment of systemic right ventricle (RV) function is a key point in the follow-up of patients with dextroposition of the great arteries (D-TGA) after the atrial switch procedure. Cardiac magnetic resonance (CMR) is considered the reference standard but is not feasible for a considerable number of patients. Experience with the application of 2-dimensional speckle tracking echocardiography for the assessment of systemic RV function in such patients is very limited, and the cutoff strain value differentiating normal and subnormal RV function is missing.


METHODS
We prospectively examined, with echocardiography and CMR, 40 patients with D-TGA (mean age, 25.6 ± 5 years; 25 men; 33 after the Senning, 7 after the Mustard procedure) who attended a tertiary adult congenital heart disease centre.


RESULTS
There was a linear correlation between global longitudinal strain (GLS) and CMR systemic RV ejection fraction (EF) values (r = 0.4; P = 0.01), systemic RV fractional area change and CMR systemic RV EF (r = 0.41; P = 0.008). There was no correlation between systemic RV s', tricuspid annular plane systolic excursion or the rate of change of the systemic RV pressure with time and CMR systemic RV EF. Only 1 of 19 patients with GLS < -14.2% had CMR systemic RV EF < 45%. The GLS cutoff value of -14.2% predicted the CMR systemic RV EF of ≥ 45% with 90% specificity and 83% sensitivity. Its positive predictive value was 96%.


CONCLUSIONS
The systemic RV GLS is able to discriminate between D-TGA patients after the atrial switch with, and those without, a CMR systemic RV EF of at least 45%.
Department of Congenital Cardiac Defects, Institute of Cardiology, Warsaw, Poland. Electronic address: mlipczynska@ikard.pl.
Magdalena
M
Lipczyńska
Department of Acquired Cardiac Defects, Institute of Cardiology, Warsaw, Poland.
Piotr
P
Szymański
Department of Congenital Cardiac Defects, Institute of Cardiology, Warsaw, Poland.
Magdalena
M
Kumor
Department of Congenital Cardiac Defects, Institute of Cardiology, Warsaw, Poland.
Anna
A
Klisiewicz
Department of Cardiomyopathy, Institute of Cardiology, Warsaw, Poland.
Łukasz
Ł
Mazurkiewicz
Department of Congenital Cardiac Defects, Institute of Cardiology, Warsaw, Poland.
Piotr
P
Hoffman
D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D015331:Cohort Studies; D018618:Echocardiography, Doppler, Color / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D013318:Stroke Volume / Q000502:physiology*; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000000981:diagnostic imaging* / Q000601:surgery*; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult