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February 1, 2018International Journal of CardiologyOpen Access

Role of myocardial collagen degradation and fibrosis in right ventricle dysfunction in transposition of the great arteries after atrial switch

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Key result

Myocardial collagen degradation explains ~85% of sRVEF variance in patients with D-TGA.

  • R2 = 0.85
  • P<0.01
  • n=74

Why the study?

Heart failure is a serious event in patients with transposition of the great arteries after atrial redirection surgery, and the association between myocardial fibrosis and systemic right ventricle dysfunction needed clarification.

Population

48 patients with atrially switched D-TGA and 26 healthy subjects

Comparison

Patients with atrially switched D-TGA vs healthy subjects

Design

Prospective cross-sectional study using echocardiography and cardiac magnetic resonance imaging

Authors

MLMagalie LadouceurSBStéphanie BaronVNValérie Nivet‐Antoine

Discussion

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Member takes

Overview

Myocardial fibrosis may associate with sRV dysfunction in D-TGA; leaves open causal links and need for longitudinal imaging studies.

Study Design

Type

Cross-Sectional (n=74)

Structured PICO

P
Population
48 patients with atrially switched D-TGA and 26 healthy subjects prospectively assessed for myocardial fibrosis and right ventricle dysfunction.
C
Comparator
26 healthy subjects
O
Outcome
Association between myocardial fibrosis (assessed by late gadolinium enhancement and serum collagen turnover biomarkers) and systolic and diastolic systemic right ventricle (sRV) dysfunctionsurrogate

Main Result

Effect estimate: R2 = 0.85

p-value: p=<0.01

In patients with D-TGA after atrial switch, systemic right ventricular dysfunction is strongly associated with myocardial collagen degradation and fibrosis, suggesting a potential therapeutic target.

Cite This Study

Ladouceur et al. (2018) conducted a cross-sectional in Transposition of the great arteries (D-TGA) after atrial switch (n=74). Myocardial fibrosis and collagen degradation vs. Healthy subjects / lower fibrosis levels was evaluated on Systemic right ventricular ejection fraction (sRVEF) (R2 = 0.85, p=<0.01). Myocardial collagen degradation, measured by the pro-MMP1:TIMP1 ratio, was the strongest determinant of systemic right ventricular ejection fraction in patients with D-TGA (R2=0.85, p<0.01).

synapsesocial.com/papers/6aabc680300de2807df783afhttps://doi.org/10.1016/j.ijcard.2018.01.100
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Also Consider

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

  1. 1Impaired atrioventricular transport in patients with transposition of the great arteries palliated by atrial switch and preserved systolic right ventricular function: A magnetic resonance imaging study2017 · 12 citations
  2. 2Diffuse myocardial fibrosis in the systemic right ventricle of patients late after Mustard or Senning surgery: an equilibrium contrast cardiovascular magnetic resonance study2013 · 69 citations
  3. 3Late Gadolinium Enhancement Cardiovascular Magnetic Resonance of the Systemic Right Ventricle in Adults With Previous Atrial Redirection Surgery for Transposition of the Great Arteries2005 · 292 citations
  4. 4Quantification of Diffuse Myocardial Fibrosis and Its Association With Myocardial Dysfunction in Congenital Heart Disease2010 · 265 citations
  5. 5Myocardial Fibrosis as an Early Manifestation of Hypertrophic Cardiomyopathy2010 · 714 citations