Cardiovascular response to physical exercise in adult patients after atrial correction for transposition of the great arteries assessed with magnetic resonance imaging

• Published in: British heart journal 2004-06, Vol.90 (6), p.678-684
• Main Authors: Roest, A A W, Lamb, H J, van der Wall, E E, Vliegen, H W, van den Aardweg, J G, Kunz, P, de Roos, A, Helbing, W A
• Format: Article
• Language: English
• Subjects: Adult; atrial correction; Biological and medical sciences; Blood Pressure - physiology; Carbon dioxide; Cardiac arrhythmia; cardiac function; Cardiology. Vascular system; Congenital Heart Disease; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Exercise; Exercise - physiology; Exercise Test; Female; Flow velocity; Heart; Heart Atria - surgery; Heart rate; Heart Rate - physiology; Humans; Magnetic Resonance Angiography - methods; Magnetic resonance imaging; Male; Medical sciences; MRI; New York Heart Association; NYHA; Oxygen Consumption - physiology; TFEPI; TGA; Transposition of Great Vessels - physiopathology; Transposition of Great Vessels - surgery; transposition of the great arteries; turbofield echo planar imaging; Veins & arteries; Ventricular Function - physiology; Ventricular Function, Left - physiology; Ventricular Function, Right - physiology
• ISSN: 1355-6037; 0007-0769; 1468-201X
• DOI: 10.1136/hrt.2003.023499

Objective: To assess with magnetic resonance imaging (MRI) cardiovascular function in response to exercise in patients after atrial correction of transposition of the great arteries (TGA). Methods: Cardiac function at rest and during submaximal exercise was assessed with MRI in 27 patients with TGA (mean (SD) age 26 (5) years) late (23 (2) years) after atrial correction and in 14 control participants (25 (5) years old). Results: At rest, only right ventricular ejection fraction was significantly lower in patients than in controls (56 (7)% v 65 (7)%, p < 0.05). In response to exercise, increases in right ventricular end diastolic (155 (55) ml to 163 (57) ml, p < 0.05) and right ventricular end systolic volumes (70 (34) ml to 75 (36) ml, p < 0.05) were observed in patients. Furthermore, right and left ventricular stroke volumes and ejection fraction did not increase significantly in patients. Changes in right ventricular ejection fraction with exercise correlated with diminished exercise capacity (r  =  0.43, p < 0.05). Conclusions: In patients with atrially corrected TGA, MRI showed an abnormal response to exercise of both systemic right and left ventricles. Exercise MRI provides a tool for close monitoring of cardiovascular function in these patients, who are at risk for late death.