title: Assessment of myocardial function using MRI-based feature tracking in adults after atrial repair of transposition of the great arteries: Reference values and clinical utility.
abstract: BACKGROUND
  Echocardiographic parameters of ventricular deformation of the systemic right ventricle (sRV) predict adverse clinical outcome in patients after atrial repair of transposition of the great arteries (TGA). We assessed myocardial deformation on cardiac MRI (CMR) and correlated these with clinical and conventional CMR parameters in TGA patients.
  
  
  METHODS
  Retrospective analysis of CMR studies in 91 TGA patients (66% male; mean age 30.1±5.1years) at two tertiary adult congenital heart centers was conducted. Myocardial deformation was assessed by CMR-based feature tracking (FT), providing longitudinal (LS), radial (RS), and circumferential (CS) global strain for the sRV and the subpulmonary left ventricle. A subgroup of optimal TGA was defined (NYHA class I, NT-proBNP <300pg/ml, max. exercise work load ≥100watt, no significant clinical events) as a reference cohort.
  
  
  RESULTS
  There was a significant correlation between FT and conventional CMR parameters. Left ventricular ejection fraction (LVEF) correlated significantly with LV LS, RS, and CS (r between 0.24 and 0.34, p values between 0.03 and 0.005). sRVEF correlated with RV CS (r=0.56, p<0.001), and RV RS (r=0.32, p=0.007). QRS duration showed a negative correlation with RV CS (r=-0.53, p<0.001), LV RS (r=-0.34, p=0.008), and LV CS (r=-0.34, p=0.006). Reference values for the novel FT method in clinically optimal TGA patients are provided.
  
  
  CONCLUSIONS
  Assessment of myocardial function using CMR-based FT is feasible in TGA patients. FT measurements related to important prognostic clinical parameters. Furthermore, we provide for the first time reference values for TGA patients in an optimal clinical status.
authors.affiliation: Department of Cardiology & Angiology, Hannover Medical School, Hannover, Germany. Electronic address: otutarel@hotmail.com.
authors.forename: Oktay
authors.initials: O
authors.lastname: Tutarel
authors.affiliation: Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of Münster, Münster, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Orwat
authors.affiliation: Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of Münster, Münster, Germany.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Radke
authors.affiliation: Department of Cardiology & Angiology, Hannover Medical School, Hannover, Germany.
authors.forename: Mechthild
authors.initials: M
authors.lastname: Westhoff-Bleck
authors.affiliation: Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of Münster, Münster, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Vossler
authors.affiliation: Department of Clinical Radiology, University Hospital of Münster, Münster, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schülke
authors.affiliation: Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of Münster, Münster, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Baumgartner
authors.affiliation: Department of Cardiology & Angiology, Hannover Medical School, Hannover, Germany.
authors.forename: Johann
authors.initials: J
authors.lastname: Bauersachs
authors.affiliation: Department of Cardiology & Angiology, Hannover Medical School, Hannover, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Röntgen
authors.affiliation: Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of Münster, Münster, Germany.
authors.forename: Gerhard-Paul
authors.initials: GP
authors.lastname: Diller
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D004452:Echocardiography / Q000379:methods; D005260:Female; D005858:Germany; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D011379:Prognosis; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013223:Statistics as Topic; D014188:Transposition of Great Vessels / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology
keywords: Cardiac MRI; Feature tracking; Transposition of great arteries