Decreased clinical performance in TGA-ASO patients after RVOT interventions; a multicenter European collaboration.

Fecha de publicación: 15/07/2024 Fecha Ahead of Print: 05/04/2024

Autores de IIS La Fe

Francisco Buendía Fuentes

Autor
Joaquín Rueda Soriano

Autor

Participantes ajenos a IIS La Fe

Engele LJ
González-Fernández V
Mulder BJM
Ruperti-Repilado FJ
Abia RL
van der Vlist K
Gabriel H
Schrutka L
Bouchardy J
Schwerzmann M
Possner M
Greutmann M
Gallego P
Ladouceur M
Jongbloed MRM
Tobler D
Dos L
Bouma BJ

Grupos

Grupo de Investigación Clínica y Traslacional en Cardiología

Investigador Principal

Esther Roselló Lletí

Abstract

BACKGROUND: In patients with transposition of the great arteries and an arterial switch operation (TGA-ASO) right ventricular outflow tract (RVOT) obstruction is a common complication requiring one or more RVOT interventions. OBJECTIVES: We aimed to assess cardiopulmonary exercise capacity and right ventricular function in patients stratified for type of RVOT intervention. METHODS: TGA-ASO patients (=16 years) were stratified by type of RVOT intervention. The following outcome parameters were included: predicted (%) peak oxygen uptake (peak VO2), tricuspid annular plane systolic excursion (TAPSE), tricuspid Lateral Annular Systolic Velocity (TV S'), right ventricle (RV)-arterial coupling (defined as TAPSE/RV systolic pressure ratio), and N-terminal proBNP (NT-proBNP). RESULTS: 447 TGA patients with a mean age of 25.0 (interquartile range (IQR) 21-29) years were included. Patients without previous RVOT intervention (n = 338, 76%) had a significantly higher predicted peak VO2 (78.0 ± 17.4%) compared to patients with single approach catheter-based RVOT intervention (73.7 ± 12.7%), single approach surgical RVOT intervention (73.8 ± 28.1%), and patients with multiple approach RVOT intervention (66.2 ± 14.0%, p = 0.021). RV-arterial coupling was found to be significantly lower in patients with prior catheter-based and/or surgical RVOT intervention compared to patients without any RVOT intervention (p = 0.029). CONCLUSIONS: TGA patients after a successful arterial switch repair have a decreased exercise capacity. A considerable amount of TGA patients with either catheter or surgical RVOT intervention perform significantly worse compared to patients without RVOT interventions.

Datos de la publicación

ISSN/ISSNe:: 0167-5273, 1874-1754
Tipo:: Article
Páginas:: 132027-132027
DOI:: 10.1016/j.ijcard.2024.132027
Factor de Impacto:: 1,195 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Filiaciones

González-Fernández V:: Hospital Universitari Vall d'Hebron, CIBERCV and European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD Heart), Barcelona, Spain
Ruperti-Repilado FJ:: University Hospital, University of Basel, Switzerland
Abia RL:: Hospital Universitario Virgen del Rocio and European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD Heart), Seville, Spain
Buendía F:: Hospital Universitari i Politècnic La Fe and CIBERCV, València, Spain
Rueda J:: Hospital Universitari i Politècnic La Fe and CIBERCV, València, Spain
Gabriel H:: Medical University of Vienna, Austria
Schrutka L:: Medical University of Vienna, Austria
Bouchardy J:: University Hospital Lausanne, Switzerland

University Hospital of Geneva, Switzerland
Schwerzmann M:: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
Possner M:: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
Greutmann M:: University Heart Center Zurich, Switzerland
Gallego P:: Hospital Universitario Virgen del Rocio and European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD Heart), Seville, Spain
Ladouceur M:: Hôpital Européen Georges Pompidou, AP-HP, Paris Cité University, Centre de Recherche Cardiovasculaire de Paris, INSERM U970, Paris, France
Tobler D:: University Hospital, University of Basel, Switzerland
Dos L:: Hospital Universitari Vall d'Hebron, CIBERCV and European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD Heart), Barcelona, Spain