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(Circulation. 1995;92:233-239.)
© 1995 American Heart Association, Inc.

Articles

Right Ventricular Performance and Mass by Use of Cine MRI Late After Atrial Repair of Transposition of the Great Arteries

Presented in part at the 67th Scientific Sessions of the American Heart Association, Dallas, Tex, November 14-17, 1994, and published in abstract form (Circulation. 1994;90[pt 2]:I-98).

Christine H. Lorenz, PHD; Eloisa S. Walker, MD; Thomas P. Graham, Jr, MD; Thomas A. Powers, MD

From the Department of Radiology and Radiological Sciences and the Division of Pediatric Cardiology, Vanderbilt University Medical Center, Nashville, Tenn.

Correspondence to Christine H. Lorenz, PhD, Assistant Professor of Medicine, Division of Cardiology, The Jewish Hospital of St Louis at Washington University Medical Center, 216 S Kingshighway Blvd, St Louis, MO 63110.

Background The long-term adaptation of the right ventricle after atrial repair of transposition of the great arteries (TGA) remains a subject of major concern. Cine magnetic resonance imaging (MRI), with its tomographic capabilities, allows unique quantitative evaluation of both right and left ventricular function and mass. Our purpose was to use MRI and an age-matched normal population to examine the typical late adaptation of the right and left ventricles after atrial repair of TGA.

Methods and Results Cine MRI was used to study ventricular function and mass in 22 patients after atrial repair of TGA. Images were obtained in short-axis sections from base to apex to derive normalized right and left ventricular mass (RVM and LVM, g/m²), interventricular septal mass (IVSM, g/m²), RV and LV end-diastolic volumes (EDV, mL/m²), and ejection fractions (EF). Results 8 to 23 years after repair were compared with analysis of 24 age- and sex-matched normal volunteers and revealed markedly elevated RVM, decreased LVM and IVSM, normal RV size, and only mildly depressed RVEF. Only 1 of 22 patients had clinical RV dysfunction, and this patient had increased RVM.

Conclusions Cine MRI allows quantitative evaluation of both RV and LV mass and function late after atrial repair of TGA. Longitudinal studies that include these measurements should prove useful in determining the mechanism of late RV failure in these patients. On the basis of these early data, inadequate hypertrophy does not appear to be the cause of late dysfunction in this patient group.

Key Words: magnetic resonance imaging • transposition of great vessels • hypertrophy • ventricles

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