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(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

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