Key result
In patients after arterial switch operation for TGA, left atrial strain was impaired and correlated with LA size and LV function, but not with standard cardiopulmonary exercise testing parameters.
Why the study?
ASO patients may have abnormal ventriculoarterial coupling causing LV dysfunction and reduced exercise capacity, and LA strain could provide mechanistic information.
Does left atrial strain correlate with atrial size, ventricular function, and exercise capacity in patients after arterial switch operation for transposition of the great arteries?
Cohort (n=44)
Does left atrial strain correlate with atrial size, ventricular function, and exercise capacity in patients after arterial switch operation for transposition of the great arteries?
In patients who underwent arterial switch operation for TGA, left atrial strain is frequently impaired and correlates with LV function and LA size, but does not correlate with standard exercise capacity parameters.
LA strain impairment was associated with LA size and LV function but not exercise parameters after ASO for TGA; leaves open its utility as a biomarker.
Background Left atrial (LA) strain, comprising LA reservoir, conduit and contractile function could add mechanistic information of patients after arterial switch operation (ASO) for transposition of the great arteries (TGA). ASO patients might have abnormal ventriculoarterial coupling, which makes them vulnerable to left ventricle (LV) dysfunction and results in reduced exercise capacity. This explorative study aimed to evaluate the relation between LA strain, atrial size, ventricular function, and exercise data obtained by cardiopulmonary exercise testing (CPET).Methods In a cohort of 44 patients (71% male, mean age 25 ± 4 years) LA strain was measured using transthoracic speckle-tracking echocardiography. Further assessment involved standard echocardiography, CPET evaluation, and blood sampling. LA strain values were compared to normal values. Correlations were calculated. Regression analysis with all strain variables to the CPET data was performed.Results LA reservoir, conduit and contractile strain were normal in 30%, 89% and 50% of the patients, respectively. LA reservoir/contractile strain correlated to LV ejection fraction (ρ 0.310/−0.159, respectively) and LA reservoir/conduit strain correlated to the LA volume index (ρ 0.336/−0.357, respectively). None of the individual LA strain parameters were associated with the CPET variables. In multivariate regression analysis, LA contractile strain was significantly associated with the percentage of predicted maximal heart rate (β − 2.555).Conclusions These data suggest that in TGA patients after ASO repair LA strain is impaired and correlates with LA size and LV function. However, impaired LA strain wasn’t associated with the standard CPET parameters. As such, clinical significance needs to be further unravelled.
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Erard et al. (2023) conducted a cohort in Transposition of the great arteries after arterial switch operation (n=44). Left atrial strain vs. Normal values was evaluated on Relation between LA strain, atrial size, ventricular function, and exercise data. In patients after arterial switch operation for TGA, left atrial strain was impaired and correlated with LA size and LV function, but not with standard cardiopulmonary exercise testing parameters.
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