Object: In patients with the congenitally corrected transposition of great arteries (CCTGA), systemic ventricle tends to be hypertrophic due to longstanding systemic high pressure. Its coronary arterial supply is usually from morphologic right coronary system that may lead to hypoxia and dysfunction of ventricle. We assessed the hypothesis of the possibility of global and segmental wall dysfunction of systemic right ventricle in patients with the CCTGA with tissue Doppler method.
Subjects and Methods: Twelve patients with the CCTGA patients were enrolled to evaluate the wall function. Ejection fraction of systemic right ventricle, myocardial performance index (MPI), strain and strain rate were assessed.
Results: The median age was 32.5 years with a range of 4 to 66 years. No patients had hemodynamically significant ventricular septal defect. Tricuspid regurgitation (TR) of greater than grade II was shown in 66.7% of patients. Ejection fraction (EF) using M-mode and Simpson���s method was significantly lower in the CCTGA patients (48.5 짹 4.6% and 51.2 짹 4.1%, respectively, vs 63.7 짹 3.6% and 66.6 짹 3.8% respectively). 5 patients had diastolic dysfunction (3/12; pseudo-normalization pattern, 2/12; relaxation abnormality). MPI was higher in the CCTGA patients (0.61 짹0.24 vs 0.37 짹0.05). Strain and strain rate revealed segmental systemic dysfunction, and were lower in the CCTGA patients at mid and apical segment of septum and apical segment of anterior wall. The extent of dysfunctional segment was related to the age and MPI but there was no relation to TR and EF. Segmental dysfunction was more frequently shown in apical segment of each wall and its extent of apical segmental dysfunction was related to the age.
Conclusion: There was global dysfunction in the CCTGA patients. Segmental dysfunction was especially shown at mid and apical segment of septum and apical segment of anterior wall and more frequently at apical segment of each wall. The extent of dysfunctional segment was correlated with age.