title: Longitudinal strain of systemic right ventricle correlates with exercise capacity in adult with transposition of the great arteries after atrial switch.
abstract: BACKGROUND
  Systemic right ventricle (sRV) dysfunction in d-transposition of the great arteries following atrial switch (d-TGA) is associated with increased mortality. We aimed to characterize maladaptive sRV mechanisms in d-TGA patients, analyzing relation of echocardiographic parameters of sRV systolic function to objective measurements of exercise capacity.
  
  
  METHODS
  Forty-seven adult patients with d-TGA and atrial switch (mean age 31.6±4.2years) underwent conventional echocardiography, bidimensional strain (2D-strain), cardiac magnetic resonance (CMR) imaging and cardiopulmonary exercise evaluation on the same day. Those with median peak oxygen uptake (VO2)>64.5% (n=23) constituted group A, those with VO2≤64.5% (n=24) constituted group B and 23 healthy age and gender matched subjects constituted the control group.
  
  
  RESULTS
  In group A, global longitudinal peak systolic 2D-strain (GLS) of sRV was significantly reduced compared to GLS of normal RV and LV in the healthy control group (p<0.01), however peak longitudinal 2D strain was similar at basal and mid-segment of sRV free wall than normal LV. In group B, GLS was significantly reduced compared to group A (-10.9±2.9% vs -13.1±2.3%, p<0.05), mostly due to significant decrease of interventricular septum longitudinal strain. Other echocardiographic systolic parameters were not significantly different between groups A and B. Only sRV GLS showed significant correlation with functional capacity as measured by VO2 (r=0.42, p<0.01), while CMR RVEF did not.
  
  
  CONCLUSIONS
  GLS of sRV predicts functional capacity and may be more sensitive than CMR RVEF in detecting early myocardial damage of sRV in patients with d-TGA and atrial switch.
authors.affiliation: INSERM U970, Paris Cardiovascular Research Centre, Université Paris-Descartes, France; Department of Paediatric Cardiology, Centre de référence des Malformations Cardiaques Congénitales Complexes, M3C, Hôpital Necker Enfants malades, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, Paris, France; Adult Congenital Heart Disease Unit, Cardiology Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, France. Electronic address: magalie.ladouceur@aphp.fr.
authors.forename: Magalie
authors.initials: M
authors.lastname: Ladouceur
authors.affiliation: Department of Cardiovascular Radiology, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, France.
authors.forename: Alban
authors.initials: A
authors.lastname: Redheuil
authors.affiliation: INSERM U970, Paris Cardiovascular Research Centre, Université Paris-Descartes, France; Department of Cardiovascular Radiology, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Soulat
authors.affiliation: Service de Physiologie - Clinique de la Dyspnée, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Delclaux
authors.affiliation: Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Centre d'Investigation Clinique, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, F-75015 Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Azizi
authors.affiliation: Baylor College of Medicine, Houston, TX, USA.
authors.forename: Mehul
authors.initials: M
authors.lastname: Patel
authors.affiliation: Clinical Research Unit, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Chatellier
authors.affiliation: Department of Paediatric Cardiology, Centre de référence des Malformations Cardiaques Congénitales Complexes, M3C, Hôpital Necker Enfants malades, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, Paris, France; Adult Congenital Heart Disease Unit, Cardiology Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Legendre
authors.affiliation: Department of Paediatric Cardiology, Centre de référence des Malformations Cardiaques Congénitales Complexes, M3C, Hôpital Necker Enfants malades, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, Paris, France; Adult Congenital Heart Disease Unit, Cardiology Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Iserin
authors.affiliation: Department of Paediatric Cardiology, Centre de référence des Malformations Cardiaques Congénitales Complexes, M3C, Hôpital Necker Enfants malades, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, Paris, France; Adult Congenital Heart Disease Unit, Cardiology Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, France.
authors.forename: Younes
authors.initials: Y
authors.lastname: Boudjemline
authors.affiliation: Department of Paediatric Cardiology, Centre de référence des Malformations Cardiaques Congénitales Complexes, M3C, Hôpital Necker Enfants malades, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, Paris, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Bonnet
authors.affiliation: INSERM U970, Paris Cardiovascular Research Centre, Université Paris-Descartes, France; Department of Cardiovascular Radiology, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Mousseaux
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004452:Echocardiography; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D011446:Prospective Studies; D014188:Transposition of Great Vessels / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology*; D016278:Ventricular Function, Right
keywords: Magnetic resonance imaging; Strain; Systemic right ventricle; Transposition of the great arteries