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Heart 2004;90:678-684 doi:10.1136/hrt.2003.023499
  • Congenital heart disease

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

  1. A A W Roest1,*,
  2. H J Lamb2,
  3. E E van der Wall3,‡,
  4. H W Vliegen3,
  5. J G van den Aardweg4,
  6. P Kunz2,
  7. A de Roos2,‡,
  8. W A Helbing1,†
  1. 1Department of Paediatric Cardiology, Leiden University Medical Centre, Leiden, the Netherlands
  2. 2Department of Radiology, Leiden University Medical Centre
  3. 3Department of Cardiology Leiden University Medical Centre
  4. 4Department of Pulmonology, Leiden University Medical Centre
  1. Correspondence to:
    Dr A de Roos
    Department of Radiology C2-S, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, Netherlands; a.de_rooslumc.nl
  • Accepted 16 October 2003

Abstract

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.

Footnotes

  • ↵* Also the Departments of Radiology and Cardiology, Leiden University Medical Centre, and the Interuniversity Cardiology Institute of The Netherlands, Utrecht, Netherlands

  • ↵† Also the Department of Paediatric Cardiology, Erasmus Medical Centre-Sophia’s Children Hospital, Dr Molewaterplein 60, 3000 CB Rotterdam, Netherlands

  • ↵‡ Also the Interuniversity Cardiology Institute of The Netherlands

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