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Comparison of segmental and global systemic ventricular function at rest and during dobutamine stress between patients with transposition and congenitally corrected transposition

Published online by Cambridge University Press:  22 April 2005

Janna van der Zedde ,
Thomas Oosterhof ,
Igor I. Tulevski ,
Hubert W. Vliegen  and
Barbara J. M. Mulder
Janna van der Zedde
Affiliation:
Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands
Thomas Oosterhof
Affiliation:
Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands
Igor I. Tulevski
Affiliation:
Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands
Hubert W. Vliegen
Affiliation:
Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
Barbara J. M. Mulder
Affiliation:
Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands
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Abstract

The aim of the study was to evaluate segmental and global right ventricular function at rest and during stress in patients having a systemic morphologically right ventricle. We studied 17 patients after atrial correction for transposition, 13 with congenitally corrected transposition, and 11 age-matched controls using cardiovascular magnetic resonance at rest and during stress with dobutamine given at 15 micrograms per kilogram per minute. Blood was drawn to obtain levels of brain natriuretic peptide. Right ventricular ejection fraction was calculated, and wall-motion and wall-thickening were assessed, in 4 segments of a midventricular slice. The findings for the systemic right ventricle were compared to the left ventricle in controls. Patients with transposition showed a decreased ejection fraction at rest (57 percent versus 69 percent, p equal to 0.005), decreased wall motion of the anterior, lateral and septal wall (p less than 0.01, p less than 0.01, and p less than 0.01) and decreased thickening of the lateral wall (p less than 0.01). Patients with congenitally corrected transposition showed normal ejection fraction, wall thickening, and wall motion at rest. During dobutamine stress, we found no significant differences in wall motion and thickening between the two groups. Ejection fraction, also increased to comparable values during stress, at 67 percent versus 66 percent, p not being significant. In both groups, we observed similarly increased levels of brain natriuretic peptide (p equal to 0.02 and 0.03, respectively). We conclude that only patients with transposition showed segmental wall motion and wall thickening abnormalities at rest. After dobutamine stress, however, segmental and global right ventricular dysfunction was similar in both groups.

Keywords

Congenital heart diseasecardiovascular magnetic resonancewall motion
Type
Original Article
Information
Cardiology in the Young , Volume 15 , Issue 2 , March 2005 , pp. 148 - 153
Copyright
© 2005 Cambridge University Press

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