Circ Cardiovasc Imaging. 2015 May;8(5). pii: e002628. doi: 10.1161/CIRCIMAGING.114.002628.
Systemic right ventricular fibrosis detected by cardiovascular magnetic resonance is associated with clinical outcome, mainly new-onset atrial arrhythmia, in patients after atrial redirection surgery for transposition of the great arteries.
Rydman R1, Gatzoulis MA1, Ho SY1, Ernst S1, Swan L1, Li W1, Wong T1, Sheppard M1, McCarthy KP1, Roughton M1, Kilner PJ1, Pennell DJ1, Babu-Narayan SV2.
Comment: Ventricular fibrosis is a late sequela in adult patients with a systemic right ventricle (RV) due to an atrially corrected transposition of the great arteries. In patients with acquired (left-sided) ventricular dysfunction, ventricular fibrosis has prognostic significance. Although previous cross-sectional studies suggest prognostic significance of systemic RV fibrosis as well, the current study is the first prospective study on the matter. Fifty-five patients (27+/-7 years; 50 Mustard, 5 Senning) underwent late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) to detect ventricular fibrosis, and were followed-up for 7.8 years. LGE was present in 31 (56%) of patients. Its presence was associated with increased risk of reaching composite clinical outcome (sustained tachy-arrhythmia, heart failure related admission/transplantation/death) in adult patients with a systemic RV. As LGE seems widely present in adult patients with a systemic RV, and its presence has important prognostic significance, the authors propose that LGE CMR should be incorporated into routine risk stratification in these patients.