268: Right ventricular function with standard and speckle-tracking echocardiography and clinical tolerance in adults with D-transposition of the great arteries post atrial switch

Abstract

1/To determine the association between systolic and diastolic function of the systemic right ventricle (RV) evaluated by echocardiography and exercise capacity, and BNP.2/ To determine the prognostic value of deformation parameters of the sRV in D-transposition of the great arteries and prior atrial switch 20 patients with D-TGV and prior atrial switch (mean age 29±8 years, 6 women) were prospectively evaluated. The systolic and diastolic function of systemic RV were studied using standard ultrasound parameters, and speckle tracking to measure global longitudinal strain (GS), global systolic strain rate (GSRs), global early diastolic strain rate (GSRe), systolic twist and diastolic untwist of sRV. Echographic data were compared with maximum oxygen uptake and BNP performed in the same day. Relationship with clinical events was studied subsequently. A comparison with 20 controls matched for age and sex is being GS, GSRs, GSRe, systolic twist and diastolic untwist of systemic RV were -11.1±2.9%, -1.2±2.4 sec-1, 0.9±1.2 sec-1, 2.4±2.3 ° and -3.5±4.9 ° respectively. No correlation was found between systemic RV diastolic parameters (E, E / A, E / Ea, isovolumic relaxation time, GSRe, and diastolic untwist) and maximum oxygen uptake or BNP. A significant correlation was found only between GS and maximum oxygen uptake (p=0.001). In univariate analysis, parameters of systolic function (S wave peak at tricuspid annulus, GS, GSRS, systolic torsion) were significantly associated to heart failure. In multivariate analysis only peak S wave at the tricuspid annulus (p=0.01) and GS (p <0.0001) were significantly associated with cardiovascular events. The GS is strongly correlated with exercise capacity and cardiovascular events in the TGA palliated by atrial switch. A study on a larger sample will confirm these results.