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February 6, 2013European Heart Journal - Cardiovascular Imaging

Diffuse myocardial fibrosis in the systemic right ventricle of patients late after Mustard or Senning surgery: an equilibrium contrast cardiovascular magnetic resonance study

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Why the study?

Is diffuse myocardial fibrosis (measured by ECV on CMR) increased in the systemic right ventricle of adults late after Mustard or Senning surgery compared to healthy controls?

Population

14 adults presenting to a specialist clinic late after atrial redirection surgery for transposition of the…

Comparison

Equilibrium contrast cardiovascular magnetic… vs 14 age- and sex-matched healthy volunteers

Design

Case-control

Authors

CPCarla M. PlymenDSDaniel SadoATAndrew M. Taylor

Discussion

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Overview

Elevated septal ECV in TGA may reflect fibrosis; hypothesis-generating and requires prospective validation before clinical use.

Structured PICO

Is diffuse myocardial fibrosis (measured by ECV on CMR) increased in the systemic right ventricle of adults late after Mustard or Senning surgery compared to healthy controls?

P
Population
14 adults presenting to a specialist clinic late after atrial redirection surgery (Mustard-Senning operations) for transposition of the great arteries (TGA) (8 Mustard, 6 female, median age 33).
I
Intervention
Equilibrium contrast cardiovascular magnetic resonance (CMR) imaging
C
Comparator
14 age- and sex-matched healthy volunteers
O
Outcome
Extracellular volume (ECV) in the septum and right ventricular (RV) free wallsurrogate

Adults late after Mustard or Senning surgery for TGA exhibit increased septal interstitial expansion on CMR, which correlates with NT-proBNP and chronotropic incompetence.

Limitations

  • RV free wall ECV was difficult to measure due to heavy trabeculation, sternal wires, and blood pool, resulting in poor inter-observer reproducibility

Cite This Study

Plymen et al. (2013) studied this question.

synapsesocial.com/papers/6a1bc0cf26cb5670aa9ccf40https://doi.org/10.1093/ehjci/jet014
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The relationship of systemic right ventricular function to ECG parameters and NT-proBNP levels in adults with transposition of the great arteries late after Senning or Mustard surgery2010 · 51 citations
  2. 2Right Ventricular Performance and Mass by Use of Cine MRI Late After Atrial Repair of Transposition of the Great Arteries1995 · 125 citations
  3. 3Cardiopulmonary exercise performance in adult survivors of the Mustard procedure2001 · 54 citations
  4. 4Characterising the myocardial interstitial space: the clinical relevance of non-invasive imaging2012 · 95 citations
  5. 5Insights into sick sinus syndrome from an inducible mouse model2010 · 42 citations