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大动脉右转位成年患者的左心房容积与形变分析(来自CSONGRAD注册研究和MAGYAR-Path研究的见解)

Left Atrial Volumetric and Deformation Analysis in Adult Patients with Dextro-Transposition of the Great Arteries (Insights from the CSONGRAD Registry and MAGYAR-Path Study).

作者信息

Nemes Attila, Rácz Gergely, Kormányos Árpád, Domsik Péter, Kalapos Anita, Gyenes Nándor, Ambrus Nóra, Bogáts Gábor, Hartyánszky István, Havasi Kálmán

机构信息

2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, H-6725 Szeged, Hungary.

出版信息

J Clin Med. 2020 Feb 7;9(2):463. doi: 10.3390/jcm9020463.

Abstract

BACKGROUND

In complete or dextro-transposition of the great arteries (dTGA), the aorta and the pulmonary artery are transposed. The present study was designed to examine dTGAassociated left atrial (LA) volumetric and functional abnormalities in adult patients late after repair and to compare their results to those of healthy controls.

METHODS

The present study consisted of 15 dTGA patients (30.3 ± 8.1 years, 9 males), the patients had Mustard (n = 8) or Senning (n = 7) procedure performed. Their results were compared to those of 36 age- and gender-matched healthy subjects (28.7 ± 1.5 years, 24 males).

RESULTS

Increased maximum LA volume and reduced LA emptying fractions respecting the cardiac cycle could be demonstrated in our dTGA patients. LA stroke volumes representing all LA functions were significantly reduced. Peak LA circumferential, longitudinal, and area strains and LA circumferential, longitudinal, and area strains measured at atrial contraction were reduced in our dTGA patients. Most LA strains were reduced in patients having Mustard surgery compared to controls and patients undergoing Senning operation.

CONCLUSIONS

Significant LA volumetric and functional abnormalities could be demonstrated in adult patients with dTGA late after repair. Senning procedure seems to have more beneficial long-term effects on LA volumetric and functional features as compared to the Mustard procedure.

摘要

背景

在完全性大动脉转位(dTGA)中,主动脉和肺动脉发生转位。本研究旨在检查成年患者修复术后晚期与dTGA相关的左心房(LA)容积和功能异常,并将其结果与健康对照者的结果进行比较。

方法

本研究纳入了15例dTGA患者(年龄30.3±8.1岁,男性9例),这些患者接受了Mustard手术(n = 8)或Senning手术(n = 7)。将他们的结果与36例年龄和性别匹配的健康受试者(年龄28.7±1.5岁,男性24例)的结果进行比较。

结果

在我们的dTGA患者中,可以证明最大左心房容积增加,且在心动周期中左心房排空分数降低。代表所有左心房功能的左心房每搏量显著降低。我们的dTGA患者在心房收缩时测量的左心房圆周应变、纵向应变和面积应变以及峰值左心房圆周应变、纵向应变和面积应变均降低。与对照组和接受Senning手术的患者相比,接受Mustard手术的患者大多数左心房应变降低。

结论

在成年dTGA患者修复术后晚期可证明存在显著的左心房容积和功能异常。与Mustard手术相比,Senning手术似乎对左心房容积和功能特征具有更有益的长期影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acfe/7074319/9dabd1621e16/jcm-09-00463-g001.jpg

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