Tricuspid Annular Plane Systolic Excursion for the Assessment of Ventricular Function in Adults Operated on with Mustard Procedure for Complete Transposition of the Great Arteries

De, Enrico; Bondanza, Sara; Calevo, Maria Grazia; Trocchio, Gianluca; Lupi, Gabriele; Domenicucci, Stefano; Marasini, Maurizio

doi:10.1111/chd.12135

Cited by 27 publications

(18 citation statements)

References 25 publications

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“…(55) Importantly, “normal” reproducible values for some of these metrics are emerging. (55–60) Volumetric 3D analysis of the RV overcomes geometric assumptions and is often reliable. (61–63) Knowledge-based reconstruction of systemic RV from specific data based algorithms is a promising new technique but is user dependent and reliant upon adequate acoustic windows and sector size.…”

Section: Discussionmentioning

confidence: 99%

Clinical research priorities in adult congenital heart disease

Cotts

Khairy

Opotowsky

et al. 2014

International Journal of Cardiology

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Background Adult congenital heart disease (ACHD) clinicians are hampered by the paucity of data to inform clinical decision-making. The objective of this study was to identify priorities for clinical research in ACHD. Methods A list of 45 research questions was developed by the Alliance for Adult Research in Congenital Cardiology (AARCC), compiled into a survey, and administered to ACHD providers. Patient input was sought via the Adult Congenital Heart Association at community meetings and online forums. The 25 top questions were sent to ACHD providers worldwide via an online survey. Each question was ranked based on perceived priority and weighted based on time spent in ACHD care. The top 10 topics identified are presented and discussed. Results The final online survey yielded 139 responses. Top priority questions related to tetralogy of Fallot (timing of pulmonary valve replacement and criteria for primary prevention ICDs), patients with systemic right ventricles (determining the optimal echocardiographic techniques for measuring right ventricular function, and indications for tricuspid valve replacement and primary prevention ICDs), and single ventricle/Fontan patients (role of pulmonary vasodilators, optimal anticoagulation, medical therapy for preservation of ventricular function, treatment for protein losing enteropathy). In addition, establishing criteria to refer ACHD patients for cardiac transplantation was deemed a priority. Conclusions The ACHD field is in need of prospective research to address fundamental clinical questions. It is hoped that this methodical consultation process will inform researchers and funding organizations about clinical research topics deemed to be of high priority.

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Section: Discussionmentioning

confidence: 99%

Clinical research priorities in adult congenital heart disease

Cotts

Khairy

Opotowsky

et al. 2014

International Journal of Cardiology

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“…Similarly, patients with d-transposition of the great arteries and systemic RVs after atrial redirection procedures (Mustard/Senning operations) also demonstrate a predominance of circumferential strain over longitudinal strain on speckle-tracking echocardiography of the RV [1, 7, 8, 23]. Values of TAPSE are diminished in this population as well and correlate poorly with RVEF [4, 8]. …”

Section: Discussionmentioning

confidence: 99%

Tricuspid Annular Plane Systolic Excursion Does Not Correlate With Right Ventricular Ejection Fraction in Patients With Hypoplastic Left Heart Syndrome After Fontan Palliation

et al. 2014

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Tricuspid annular plane systolic excursion (TAPSE) reflects longitudinal myocardial shortening, the main component of right ventricular (RV) contraction in normal hearts. To date, TAPSE has not been extensively studied in patients with hypoplastic left heart syndrome (HLHS) and systemic RVs after Fontan palliation. This retrospective study investigated HLHS patients after Fontan with cardiac magnetic resonance (CMR) performed between 1 January 2010 and 1 August 2012 and transthoracic echocardiogram (TTE) performed within 6 months of CMR. The maximal apical displacement of the lateral tricuspid valve annulus was measured on CMR (using four-chamber cine images) and on TTE (using two-dimensional apical views). To create TTE–TAPSE z-scores, published reference data were used. Intra- and interobserver variability was tested with analysis of variance. Inter-technique agreement of TTE and CMR was tested with Bland–Altman analysis. In this study, 30 CMRs and TTEs from 29 patients were analyzed. The age at CMR was 14.1 ± 7.1 years, performed 11.9 ± 7.8 years after Fontan. For CMR–TAPSE, the intraclass correlation coefficients for inter- and intraobserver variability were 0.89 and 0.91, respectively. The TAPSE measurements were 0.57 ± 0.2 cm on CMR and 0.70 ± 0.2 cm on TTE (TTE–TAPSE z score, −8.7 ± 1.0). The mean difference in TAPSE between CMR and TTE was −0.13 cm [95 % confidence interval (CI) −0.21 to −0.05], with 95 %limits of agreement (−0.55 to 0.29 cm). The study showed no association between CMR–TAPSE and RVEF (R = 0.08; p = 0.67). In patients with HLHS after Fontan, TAPSE is reproducible on CMR and TTE, with good agreement between the two imaging methods. Diminished TAPSE suggests impaired longitudinal shortening in the systemic RV. However, TAPSE is not a surrogate for RVEF in this study population.

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“…Among the standard echocardiographic indices of the systolic RV function, only fractional area change differed between the subgroups, and the nonparametric indices of the systolic RV function were similar in the overweight/obese and normal weight patients. However, these parameters are usually applied to evaluate the subpulmonary RV, and some investigators suggested that they are not suitable for systemic RV assessment [14,15].…”

Section: Discussionmentioning

confidence: 99%

Assessment of systemic right ventricular function in adult overweight and obese patients with congenitally corrected transposition of the great arteries

Kowalik¹,

Klisiewicz²,

Biernacka³

et al. 2017

Kardiol Pol

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A b s t r a c t Background:In congenitally corrected transposition of the great arteries the right ventricle (RV) supports systemic circulation, and patients are prone to develop heart failure over time. Chronic volume overload secondary to obesity may contribute to premature dysfunction of the systemic RV. Aim:The aim of our study was to assess the systemic RV function in overweight/obese adult patients with congenitally corrected transposition of the great arteries. Methods:Transthoracic echocardiographic studies and laboratory testing (N-terminal pro-B-type natriuretic peptide [NT-proBNP] assessment) were performed in patients with congenitally corrected transposition, who were scheduled for a routine examination, and the body mass index was calculated for each patient. Results:We studied 56 adults (31 men; mean age 33.9 years); 22 of whom were overweight (body mass index [BMI] of 25-29.9 kg/m 2 ) or obese (BMI of 30 kg/m 2 or more), and 34 of whom were normal weight (BMI below 25 kg/m 2 ). Age, gender, heart rate, and blood pressure were similar in both groups. The mean NT-proBNP levels were not significantly different. On echocardiography, the overweight/obese patients had a decreased systemic RV fractional area change (0.38) compared to normal weight patients (0.43); p = 0.02. Moreover, a significant reduction in the global longitudinal strain in the overweight/obese group was observed (-15.3% vs. -18.3%; p = 0.01).Conclusions: Overweight/obesity in adult patients with congenitally corrected transposition of the great arteries is associated with impaired systemic RV function.

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Tricuspid Annular Plane Systolic Excursion for the Assessment of Ventricular Function in Adults Operated on with Mustard Procedure for Complete Transposition of the Great Arteries

Abstract: Our results indicate that in these patients TAPSE is not a useful measure of RV function.

Cited by 27 publications

References 25 publications

Clinical research priorities in adult congenital heart disease

Clinical research priorities in adult congenital heart disease

Tricuspid Annular Plane Systolic Excursion Does Not Correlate With Right Ventricular Ejection Fraction in Patients With Hypoplastic Left Heart Syndrome After Fontan Palliation

Assessment of systemic right ventricular function in adult overweight and obese patients with congenitally corrected transposition of the great arteries

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