This Article Full Text Full Text (PDF) All Versions of this Article: 110/20/3229    most recent 01.CIR.0000147284.54140.73v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Salehian, O. Articles by Therrien, J. Search for Related Content PubMed PubMed Citation Articles by Salehian, O. Articles by Therrien, J. Pubmed/NCBI databases Medline Plus Health Information MRI Scans Related Collections CT and MRI Echocardiography Pediatric and congenital heart disease, including cardiovascular surgery

(Circulation. 2004;110:3229-3233.)
© 2004 American Heart Association, Inc.

Imaging

Assessment of Systemic Right Ventricular Function in Patients With Transposition of the Great Arteries Using the Myocardial Performance Index

Comparison With Cardiac Magnetic Resonance Imaging

Omid Salehian, MD, MSc, FRCPC; Markus Schwerzmann, MD; Naeem Merchant, MD, FRCPC; Gary D. Webb, MD, FRCPC; Samuel C. Siu, MD, SM, FRCPC; Judith Therrien, MD, FRCPC

From the Toronto Congenital Cardiac Center for Adults and Echocardiographic Laboratory, Division of Cardiology, Department of Medicine (O.S., M.S., G.D.W., S.C.S.), and Department of Diagnostic Imaging, Magnetic Resonance Imaging Laboratory (N.M.), Toronto General Hospital, University of Toronto, Toronto, Ontario, and Adult Congenital Heart Center, Division of Cardiology, Department of Medicine, Sir M.B. Davis Jewish General Hospital, McGill University, Montreal, Quebec (J.T.), Canada.

Correspondence to Dr Judith Therrien, Sir M.B. Davis Jewish General Hospital, 3755 Cote Ste. Catherine, Montreal, Quebec, Canada, H3T 1E2. E-mail jtherrien{at}cardio.jgh.mcgill.ca

Received March 4, 2004; de novo received May 10, 2004; accepted June 29, 2004.

Background— Assessment of systemic right ventricular (RV) function is a key point in the follow-up of patients with transposition of the great arteries (TGA). Current echocardiographic assessment of RV function is at best an estimate, and cardiac magnetic resonance (CMR) is considered the gold standard. However, this technique is expensive, has limited availability, and requires significant expertise to acquire and interpret the images. The myocardial performance index (MPI) has recently been studied for assessment of pulmonary RV function and shows promise as a simple yet powerful tool for assessing patients with RV dysfunction of various origins. We set out to compare MPI and CMR assessment of systemic RV function in patients with TGA.

Methods and Results— Data from patients with TGA (11 with congenitally corrected TGA, 18 with surgically corrected TGA) who had CMR within 6 months of their echocardiogram were reviewed. The average systemic RV ejection fraction (RVEF) by CMR was 39.4±11.4%, and the systemic RVMPI for this group was 0.56±0.21. There was a strong negative correlation between the systemic RVMPI and systemic RVEF by CMR (r=–0.82, P<0.01). The systemic RVEF can be estimated from this formula: RVEF=65%–(45.2xMPI).

Conclusions— MPI can be used in patients with systemic RVs to assess global function and to estimate an EF with good accuracy.

Key Words: echocardiography • heart defects, congenital • magnetic resonance imaging • transposition of great vessels • ventricles

This article has been cited by other articles:

				C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease): Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, December 2, 2008; 118(23): e714 - e833. [Full Text] [PDF]

				C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Adults With Congenital Heart Disease): Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, December 2, 2008; 118(23): 2395 - 2451. [Full Text] [PDF]

				P-C Chow, X-C Liang, E W Y Cheung, W W M Lam, and Y-F Cheung New two-dimensional global longitudinal strain and strain rate imaging for assessment of systemic right ventricular function Heart, July 1, 2008; 94(7): 855 - 859. [Abstract] [Full Text] [PDF]

				D. W. Quinn, S. P. McGuirk, C. Metha, P. Nightingale, J. V. de Giovanni, R. Dhillon, P. Miller, O. Stumper, J. G. Wright, D. J. Barron, et al. The morphologic left ventricle that requires training by means of pulmonary artery banding before the double-switch procedure for congenitally corrected transposition of the great arteries is at risk of late dysfunction. J. Thorac. Cardiovasc. Surg., May 1, 2008; 135(5): 1137 - 1144.e2. [Abstract] [Full Text] [PDF]

				Y.-Y. Lam, M. G. Kaya, O. Goktekin, M. A. Gatzoulis, W. Li, and M. Y. Henein Restrictive Right Ventricular Physiology: Its Presence and Symptomatic Contribution in Patients With Pulmonary Valvular Stenosis J. Am. Coll. Cardiol., October 9, 2007; 50(15): 1491 - 1497. [Abstract] [Full Text] [PDF]

				C. A. Warnes Transposition of the Great Arteries Circulation, December 12, 2006; 114(24): 2699 - 2709. [Abstract] [Full Text] [PDF]

				M. Cannesson, D. Jacques, M. R. Pinsky, and J. Gorcsan III Effects of modulation of left ventricular contractile state and loading conditions on tissue Doppler myocardial performance index Am J Physiol Heart Circ Physiol, May 1, 2006; 290(5): H1952 - H1959. [Abstract] [Full Text] [PDF]