caa a22 4500 475791371 CHVBK 20180406123711.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1023/A:1010692807154 doi (NATIONALLICENCE)springer-10.1023/A:1010692807154 Dobutamine-induced increase of right ventricular contractility without increased stroke volume in adolescent patients with transposition of the great arteries: Evaluation with magnetic resonance imaging [Elektronische Daten] [Igor Tulevski, Peter Lee, Maarten Groenink, Ernst van der Wall, Jaap Stoker, P.G. Pieper, Hans Romkes, Alexander Hirsch, Barbara Mulder] Objective: Prognosis in patients with surgically corrected (Senning or Mustard) transposition of the great arteries (TGA) depends mainly on right ventricular (RV) function and RV functional reserve. We examined the role of dobutamine stress in the early detection of RV dysfunction in asymptomatic or slightly symptomatic patients with TGA using magnetic resonance imaging (MRI). Design and patients: Twelve asymptomatic or slightly symptomatic patients with chronic RV pressure overload, surgically corrected (Mustard or Senning) TGA (age 22.8 (±3.4) years; New York Heart Association (NYHA) class I/II) and nine age matched healthy volunteers (age 27.3 (±4.4) years) were included. MRI was applied both at baseline and during dobutamine stress (start dose 5 μg/kg/min to maximum dose 15 μg/kg/min) to determine RV and left ventricular (LV) stroke volumes (SV) and ejection fraction (EF). Results: At baseline only RVEF was significantly higher in controls than in patients (71 (±9) vs. 57 (±10)%, p < 0.001), other RV parameters were not significantly different between the two examined groups: RVSV (86 (±21) vs. 72 (±27) ml, p = ns), RV end-diastolic volume (EDV) (123 (±37) vs. 123 (±33) ml, p = ns), and heart rate (61 (±10) vs. 69 (±14) bpm, p = ns), respectively. During dobutamine stress RVEF increased significantly both in controls and patients (20 (±16) vs. 17 (±18)%, p < 0.01 and p < 0.02 vs. rest, respectively), but stress RVEF was significantly higher in controls than in patients (85 (±3) vs. 66 (±7)%, p < 0.0001). RVSV increased significantly in controls (22 (±19)%, p < 0.02), and there was no significant increase in RVSV in patients (−10 (±28)%, p = ns). The controls showed no change in RVEDV (2 (±17)%, p = ns), but in patients a significant decrease in RVEDV (−24 (±15)%, p < 0.001) was observed. Maximal heart rate was significantly higher in patients than in controls (122 (±20) vs. 101 (±14) bpm, p < 0.02). Conclusion: In asymptomatic or slightly symptomatic patients with surgically corrected TGA dobutamine had a positive inotropic effect on RV, but the increased contractility was not accompanied by an appropriate increase in SV. Our data suggest inadequate RV filling in this category of patients, possibly due to rigid atrial baffles and compromised atrial function or decreased compliance due to RV hypertrophy. Kluwer Academic Publishers, 2000 dobutamine stress test nationallicence magnetic resonance imaging nationallicence right ventricle nationallicence transposition of the great arteries nationallicence Tulevski Igor Department of Cardiology, Academic Medical Center Amsterdam, The Netherlands aut Lee Peter Department of Cardiology, Academic Medical Center Amsterdam, The Netherlands aut Groenink Maarten Department of Cardiology, Academic Medical Center Amsterdam, The Netherlands aut van der Wall Ernst Department of Cardiology, Leiden University Medical Center, The Netherlands aut Stoker Jaap Department of Radiology, Academic Medical Center Amsterdam, The Netherlands aut Pieper P.G. Academic Hospital Groningen, The Netherlands aut Romkes Hans Department of Cardiology, Academic Medical Center Amsterdam, The Netherlands aut Hirsch Alexander Department of Cardiology, Academic Medical Center Amsterdam, The Netherlands aut Mulder Barbara Department of Cardiology, Academic Medical Center Amsterdam, The Netherlands aut The International Journal of Cardiac Imaging Kluwer Academic Publishers 16/6(2000-12-01), 471-478 0167-9899 16:6<471 2000 16 10554 https://doi.org/10.1023/A:1010692807154 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1010692807154 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tulevski Igor Department of Cardiology, Academic Medical Center Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Lee Peter Department of Cardiology, Academic Medical Center Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Groenink Maarten Department of Cardiology, Academic Medical Center Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- van der Wall Ernst Department of Cardiology, Leiden University Medical Center, The Netherlands aut NATIONALLICENCE 700 1- Stoker Jaap Department of Radiology, Academic Medical Center Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Pieper P.G. Academic Hospital Groningen, The Netherlands aut NATIONALLICENCE 700 1- Romkes Hans Department of Cardiology, Academic Medical Center Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Hirsch Alexander Department of Cardiology, Academic Medical Center Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Mulder Barbara Department of Cardiology, Academic Medical Center Amsterdam, The Netherlands aut NATIONALLICENCE 773 0- The International Journal of Cardiac Imaging Kluwer Academic Publishers 16/6(2000-12-01), 471-478 0167-9899 16:6<471 2000 16 10554 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer