title: Echocardiography vs magnetic resonance imaging in assessing ventricular function and systemic atrioventricular valve status in adults with congenitally corrected transposition of the great arteries.
abstract: BACKGROUND
  The survival in adults with congenitally corrected transposition of the great arteries (ccTGA) might be reduced due to dysfunction of the systemic right ventricle (sRV). The quantitative echocardiographic assessment of sRV function and tricuspid (systemic atrioventricular valve) regurgitation (TR) is still a diagnostic challenge. Thus, the aim of this study was to compare echocardiographic indices of sRV function and the degree of TR with corresponding MRI (magnetic resonance imaging)-derived parameters in adults with ccTGA.
  
  
  METHODS
  A prospective cross-sectional study of adults with ccTGA referred to a tertiary congenital heart disease center was conducted. All patients underwent transthoracic echocardiography and MRI examinations. Thirty-three adults (19F/14M, mean age 34.1 years) were included.
  
  
  RESULTS
  We found significantly lower fractional area change (FAC) and global longitudinal strain (GLS) values in patients with MRI-derived RV ejection fraction (EF) <45%. A cutoff GLS<-16.3% identified sRV EF ≥45% with a sensitivity of 77.3% and specificity of 72.7%. A very strong correlation between MRI- and echocardiography-derived TR volume was observed (r=.84; P<.0001).
  
  
  CONCLUSIONS
  GLS is the variable with the best sensitivity but less specificity to distinguish between systemic RV EF ≥45% and below 45%, and it seems to be the preferred echocardiographic index of systemic RV function in adults with ccTGA. The quantitative assessment of TR by MRI and echocardiography showed a very strong agreement in patients with ccTGA.
authors.affiliation: Department of Congenital Heart Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Kowalik
authors.affiliation: Department of Cardiomyopathy, Institute of Cardiology, Warsaw, Poland.|Magnetic Resonance Unit, Institute of Cardiology, Warsaw, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Mazurkiewicz
authors.affiliation: Department of Congenital Heart Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Mirosław
authors.initials: M
authors.lastname: Kowalski
authors.affiliation: Department of Congenital Heart Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Klisiewicz
authors.affiliation: Magnetic Resonance Unit, Institute of Cardiology, Warsaw, Poland.|Department of Radiology, Institute of Cardiology, Warsaw, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Marczak
authors.affiliation: Department of Congenital Heart Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Hoffman
mesh_terms: D000293:Adolescent; D000328:Adult; D000080041:Congenitally Corrected Transposition of the Great Arteries; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D013318:Stroke Volume; D014188:Transposition of Great Vessels / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult
keywords: cardiac magnetic resonance imaging; congenital heart disease; congenitally corrected transposition of the great arteries; myocardial strain; right ventricle; tricuspid regurgitation