Key result
Patients long-term after arterial switch operation for transposition of the great arteries had significantly impaired global longitudinal strain compared to healthy peers (-15.4% vs -23.2%, p<0.001).
Why the study?
Does arterial switch operation for transposition of the great arteries result in impaired left ventricular function compared to healthy peers in the long term?
Cross-Sectional (n=81)
No
Does arterial switch operation for transposition of the great arteries result in impaired left ventricular function compared to healthy peers in the long term?
Absolute Event Rate: -15.35% vs -23.15%
p-value: p=<0.001
Long-term survivors of the arterial switch operation for transposition of the great arteries exhibit impaired global longitudinal strain despite normal ejection fraction, suggesting sub-clinical myocardial dysfunction.
Subclinical GLS impairment after ASO signals need for cautious surveillance; leaves open its prognostic value in prospective TGA studies.
Long-term after arterial switch operation for transposition of the great arteries, abnormal coronary anatomy and altered loading conditions could compromise ventricular function. The current study investigates whether left ventricular function, measured with echocardiographic bi-plane ejection fraction and deformation imaging, in patients long term after arterial switch operation for transposition of the great arteries differs from healthy peers. A cross-sectional cohort study of patients at least 12 years after arterial switch operation was analyzed with bi-plane Simpson's left ventricular ejection fraction (LVEF) and deformation (speckle tracking) echocardiography. 81 patients, median age 20.6 (interquartile range 13.5-28.4) years, were included. LVEF was normal on average at 55.5 ± 6.1%. Global longitudinal strain (GLS) was lower in patients compared to healthy peers throughout all age groups and on pooled average (- 15.4 ± 1.1% vs. - 23.2 ± 0.9%). Although LVEF is normal on average in patients after arterial switch operation for transposition of the great arteries, GLS is impaired compared to healthy peers. The reduced GLS could indicate sub-clinical myocardial dysfunction.
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Wijk et al. (2018) conducted a cross-sectional in Transposition of the great arteries (n=81). Arterial switch operation vs. Healthy peers was evaluated on Global longitudinal strain (GLS) (p=<0.001). Patients long-term after arterial switch operation for transposition of the great arteries had significantly impaired global longitudinal strain compared to healthy peers (-15.4% vs -23.2%, p<0.001).
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