Myocardial blood flow in patients with transposition of the great arteries - risk factor for dysfunction of the morphologic systemic right ventricle late after atrial repair.

Hauser, Michael; Meierhofer, Christian; Schwaiger, Markus; Vogt, Manfred; Kaemmerer, Harald; Kuehn, Andreas

doi:10.1253/circj.CJ-14-0716

journal article

Title:: Myocardial blood flow in patients with transposition of the great arteries - risk factor for dysfunction of the morphologic systemic right ventricle late after atrial repair.
Document type:: Journal Article
Author(s):: Hauser, Michael; Meierhofer, Christian; Schwaiger, Markus; Vogt, Manfred; Kaemmerer, Harald; Kuehn, Andreas
Abstract:: Dysfunction of the morphologic systemic right ventricle (RV) is a sequela in long-term survivors with transposition of the great arteries (TGA) after atrial switch operation (AtSO). Impairment of myocardial blood flow (MBF) and coronary flow reserve (CFR) are hypothesized as predisposing factors.The study group comprised 20 patients after AtSO (22.7 ± 5.03 years) and 15 individuals with congenitally corrected transposition (ccTGA) (30.6 ± 19.4 years). MBF was quantified by positron emission tomography; controls for coronary flow were 11 healthy volunteers (26.2 ± 5.1 years). Exercise capacity, ventricular mass, function and end-diastolic volume assessed by coronary magnetic resonance (CMR), hemodynamic parameters assessed by cardiac catheterization and echocardiography, and B-type natriuretic peptide levels correlated with MBF. At rest, MBF did not differ between patients and healthy volunteers (MBFrestml·100 g(-1)·min(-1); ccTGA: 75 ± 14 vs. AtSO: 73 ± 16 vs. controls: 77 ± 15; NS). After vasodilatation, MBF increased significantly, but was significantly lower in ccTGA and AtSO groups compared with controls (MBFstressml·100 g(-1)·min(-1); ccTGA: 198 ± 38 vs. AtSO: 167 ± 46 vs. controls 310 ± 74; P<0.001). In ccTGA, CFR correlated significantly with clinical, CMR, echocardiographic and hemodynamic parameters, but for AtSO patients no significant correlation could be calculated.In patients with ccTGA, maximal coronary blood flow is attenuated and significantly correlated with ventricular function, whereas dysfunction of the morphologic systemic RV after AtSO is a multifactorial problem.
Journal title abbreviation:: Circ J
Year:: 2015
Journal volume:: 79
Journal issue:: 2
Pages contribution:: 425-31
Language:: eng
Fulltext / DOI:: doi:10.1253/circj.CJ-14-0716
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/25744754
Print-ISSN:: 1346-9843
TUM Institution:: Klinik für Kinderkardiologie und angeborene Herzfehler (Prof. Hess); Klinik und Poliklinik für Nuklearmedizin
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Kinderkardiologie und angeborene Herzfehler (DHM) (Prof. Ewert)2015

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Nuklearmedizin (Prof. Weber)2015