Engele, Leo J; González-Fernández, Víctor; Mulder, Barbara J M; Ruperti-Repilado, Francisco Javier; Abia, Raquel Ladrón; van der Vlist, Kim; Buendía, Francisco; Rueda, Joaquin; Gabriel, Harald; Schrutka, Lore; Bouchardy, Judith; Schwerzmann, Markus; Possner, Mathias; Greutmann, Matthias; Gallego, Pastora; Ladouceur, Magalie; Jongbloed, Monique R M; Tobler, Daniel; Dos, Laura and Bouma, Berto J (2024). Decreased clinical performance in TGA-ASO patients after RVOT interventions; a multicenter European collaboration. International journal of cardiology, 407(132027), p. 132027. Elsevier 10.1016/j.ijcard.2024.132027
Text
1-s2.0-S0167527324006211-main.pdf - Accepted Version Restricted to registered users only until 5 April 2025. Available under License Publisher holds Copyright. Download (1MB) |
BACKGROUND
In patients with transposition of the great arteries and an arterial switch operation (TGA-ASO) right ventricular outflow tract (RVOT) obstruction is a common complication requiring one or more RVOT interventions.
OBJECTIVES
We aimed to assess cardiopulmonary exercise capacity and right ventricular function in patients stratified for type of RVOT intervention.
METHODS
TGA-ASO patients (≥16 years) were stratified by type of RVOT intervention. The following outcome parameters were included: predicted (%) peak oxygen uptake (peak VO2), tricuspid annular plane systolic excursion (TAPSE), tricuspid Lateral Annular Systolic Velocity (TV S'), right ventricle (RV)-arterial coupling (defined as TAPSE/RV systolic pressure ratio), and NT-pro-BNP.
RESULTS
447 TGA patients with a mean age of 25.0 (interquartile range (IQR) 21-29) years were included. Patients without previous RVOT intervention (n = 338, 76%) had a significantly higher predicted peak VO2 (78.0 ± 17.4%) compared to patients with single approach catheter-based RVOT intervention (73.7 ± 12.7%), single approach surgical RVOT intervention (73.8 ± 28.1%), and patients with multiple approach RVOT intervention (66.2 ± 14.0%, p = 0.021). RV-arterial coupling was found to be significantly lower in patients with prior catheter-based and/or surgical RVOT intervention compared to patients without any RVOT intervention (p = 0.029).
CONCLUSIONS
TGA patients after a successful arterial switch repair have a decreased exercise capacity. A considerable amount of TGA patients with either catheter or surgical RVOT intervention perform significantly worse compared to patients without RVOT interventions.
Item Type: |
Journal Article (Original Article) |
---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Schwerzmann, Markus, Possner, Mathias |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1874-1754 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
08 Apr 2024 10:51 |
Last Modified: |
18 May 2024 00:15 |
Publisher DOI: |
10.1016/j.ijcard.2024.132027 |
PubMed ID: |
38583591 |
Uncontrolled Keywords: |
Arterial switch operation Peak-VO2 Re-intervention Right ventricular outflow tract obstruction Transposition of the great arteries |
BORIS DOI: |
10.48350/195739 |
URI: |
https://boris.unibe.ch/id/eprint/195739 |