Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Published online before print October 21, 2008, 10.1148/radiol.2492072013
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
2492072013v1
249/3/801    most recent
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Grotenhuis, H. B.
Right arrow Articles by de Roos, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Grotenhuis, H. B.
Right arrow Articles by de Roos, A.
(Radiology 2008;249:801-809.)
© RSNA, 2008

Cardiac Imaging

Aortic Elasticity and Left Ventricular Function after Arterial Switch Operation: MR Imaging—Initial Experience1

Heynric B. Grotenhuis, MD, Jaap Ottenkamp, MD, PhD, Duveken Fontein, MD, Hubert W. Vliegen, MD, PhD, Jos J. M. Westenberg, PhD, Lucia J. M. Kroft, MD, PhD, and Albert de Roos, MD, PhD

1 From the Departments of Radiology (H.B.G., D.F., J.J.M.W., L.J.M.K., A.d.R.), Pediatric Cardiology (H.B.G., J.O.), and Cardiology (H.W.V.), Leiden University Medical Center, Albinusdreef 2, C2-S, 2300 RC Leiden, the Netherlands. Received November 17, 2007; revision requested January 10, 2008; revision received May 9; accepted May 27; final version accepted June 9. Address correspondence to A.d.R. (e-mail: A.de_Roos{at}lumc.nl).

Purpose: To prospectively assess aortic dimensions, aortic elasticity, aortic valve competence, and left ventricular (LV) systolic function in patients after the arterial switch operation (ASO) by using magnetic resonance (MR) imaging.

Materials and Methods: Informed consent was obtained from all participants for this local ethics committee–approved study. Fifteen patients (11 male patients, four female patients; mean age, 16 years ± 4 [standard deviation]; imaging performed 16.1 years after surgery ± 3.7) and 15 age- and sex-matched control subjects (11 male subjects, four female subjects; mean age, 16 years ± 4) were evaluated. Velocity-encoded MR imaging was used to assess aortic pulse wave velocity (PWV), and a balanced turbo-field-echo sequence was used to assess aortic root distensibility. Standard velocity-encoded and multisection-multiphase imaging sequences were used to assess aortic valve function, systolic LV function, and LV mass. The two-tailed Mann-Whitney U test and Spearman rank correlation coefficient were used for statistical analysis.

Results: Patients treated with the ASO showed aortic root dilatation at three predefined levels (mean difference, 5.7–9.4 mm; P ≤ .007) and reduced aortic elasticity (PWV of aortic arch, 5.1 m/sec ± 1.2 vs 3.9 m/sec ± 0.7, P = .004; aortic root distensibility, [2.2 x 10–3] · mm Hg–1 ± 1.8 vs [4.9 x 10–3] · mm Hg–1 ± 2.9, P < .01) compared with control subjects. Minor degrees of aortic regurgitation (AR) were present (AR fraction, 5% ± 3 in patients vs 1% ± 1 in control subjects; P < .001). Patients had impaired systolic LV function (LV ejection fraction [LVEF], 51% ± 6 vs 58% ± 5 in control subjects; P = .003), in addition to enlarged LV dimensions (end-diastolic volume [EDV], 112 mL/m2 ± 13 vs 95 mL/m2 ± 16, P = .007; end-systolic volume [ESV], 54 mL/m2 ± 11 vs 39 mL/m2 ± 7, P < .001). Degree of AR predicted decreased LVEF (r = 0.41, P = .026) and was correlated with increased LV dimensions (LV EDV: r = 0.48, P = .008; LV ESV: r = 0.67, P < .001).

Conclusion: Aortic root dilatation and reduced elasticity of the proximal aorta are frequently observed in patients who have undergone the ASO, in addition to minor degrees of AR, reduced LV systolic function, and increased LV dimensions.

© RSNA, 2008