Key result
Patients with d-TGA and TOF had significantly reduced hyperaemic septal relative myocardial blood volume compared to healthy controls (0.141 and 0.134 vs 0.189 ml/ml, p=0.005).
Why the study?
Does myocardial contrast echocardiography reveal reduced myocardial microvascular density and perfusion reserve in patients with d-TGA and TOF compared to healthy controls?
Observational (n=62)
Does myocardial contrast echocardiography reveal reduced myocardial microvascular density and perfusion reserve in patients with d-TGA and TOF compared to healthy controls?
p-value: p=0.005
Patients with d-TGA and TOF exhibit reduced right ventricular myocardial microvascular density and perfusion reserve, which correlates with impaired right ventricular systolic function.
OBJECTIVE: A consequence in patients with d-transposition of the great arteries (d-TGA) and tetralogy of Fallot (TOF) is right ventricular hypertrophy (RVH) and right ventricular failure. Myocardial contrast echocardiography (MCE) permits the determination of the myocardial microvascular density reflected by the relative myocardial blood volume (rBV; ml/ml). This study was conducted to elucidate the relationship between RVH and myocardial microvascular changes by quantitative MCE in patients with d-TGA and TOF. METHODS: Three groups of individuals were included in the study: 22 patients with d-TGA, 18 patients with TOF and 22 healthy individuals (controls). MCE was performed at rest and during adenosine-induced hyperaemia. rBV and myocardial blood flow (MBF; ml/min per gram) were derived from steady state and refill sequences of ultrasound contrast agent. RESULTS: Hyperaemic septal rBV differed significantly between the groups and was highest in controls: d-TGA 0.141+/-0.060 ml/ml, TOF 0.134+/-0.080 ml/ml, controls 0.189+/-0.074 ml/ml, p=0.005. Myocardial blood flow reserve (MBFR), that is the ratio of hyperaemic to baseline MBF, differed significantly between the groups and was lowest in d-TGA (2.68+/-1.13) versus TOF (3.37+/-1.57) and controls (4.22+/-1.17, p=0.001). Hyperaemic septal rBV, MBF and MBFR showed a significant correlation with right ventricular systolic function as determined by tricuspid annular plane systolic excursion. CONCLUSIONS: Right ventricular myocardial microvascular density of the septal wall in d-TGA and TOF patients with RVH due to pressure and/or volume overload is reduced. This appears to be related to a reduced myocardial perfusion reserve and impaired right ventricular systolic function.
No takes yet. Share an insight, caveat, or question.
Rutz et al. (2010) conducted an observational in Complex congenital heart disease (d-TGA and TOF) (n=62). Complex congenital heart disease (d-TGA and TOF) vs. Healthy individuals was evaluated on Hyperaemic septal relative myocardial blood volume (rBV) (p=0.005). Patients with d-TGA and TOF had significantly reduced hyperaemic septal relative myocardial blood volume compared to healthy controls (0.141 and 0.134 vs 0.189 ml/ml, p=0.005).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: