Congenital Heart Defect, Congenital Heart Disease, Transposition of the Great Arteries
Conditions
Keywords
Congenital Heart Disease, Cardiac denervation, 123I-metaiodobenzylguanidine, Arterial switch operation
Brief summary
Cardiac denervation is inherent to the arterial switch (ASO) technique for the repair of transposition of the great arteries (TGA) and the long term reinnervation process has not been studied. We sought to describe the reinnervation status of adult patients long after the ASO, to identify areas of myocardial perfusion/innervation mismatch and to assess the relation of innervation status and exercise capacity.
Detailed description
Cardiac denervation is inherent to the arterial switch (ASO) technique for the repair of transposition of the great arteries (TGA) and the long term reinnervation process has not been studied. We sought to describe the reinnervation status of adult patients long after the ASO, to identify areas of myocardial perfusion/innervation mismatch and to assess the relation of innervation status and exercise capacity.
Interventions
OTHERNon intervention
patients without intervention
Sponsors
Hospital Universitari Vall d'Hebron Research Institute
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with transposition of the great arteries repaired with the arterial switch. * Patients aged of more than 18 years-old.
Exclusion criteria
* Pregnancy or breast-feeding. * Denial of informed consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Myocardial innervation pattern on 123I-mlBG SPECT. | 1 day | To describe the myocardial reinnervation pattern of a cohort of patients with TGA long after ASO using cardiac nuclear imaging. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Myocardial perfusion defects on cardiac nuclear imaging. | 1 day | To identify myocardial perfusion defects using cardiac nuclear imaging. |
| Myocardial innervation perfusion mismatch defects on cardiac nuclear imaging. | 1 day | To identify myocardial innervations/perfusion mismatch using cardiac nuclear imaging. |
| Treadmill exercise test. | 1 day | To determine exercise capacity (METs and double product) and chronotropic response (Maximal heart rate and heart rate increase pattern). Correlate with myocardial reinnervation pattern and sinus node reinnervation. To determine exercise induced ischeamic ST segment changes. Correlate with myocardial perfusion defects and innervation-perfusion mismatch. |
| 24 hours ECG Holter monitoring . | 1 day | To determine sinus node innervation through heart rate variability (HRV) which will be assessed by time domain variables (the standard deviation of normal RR intervals (SDNN) and the square root of the mean of the squared differences between adjacent normal RR intervals (r-MSSD)) and frequency domain variables (variance of all R-R intervals - total power (TP); power in the very low frequency range - very low frequency (VLF, 0.003-0.04 Hz); power in the low frequency range-low frequency (LF, 0.04-0.15Hz); low frequency power in normalized units-normalized low frequency; power in the high frequency range-high frequency (HF, 0.15-0.40 Hz); and high frequency power in normalized units-normalized high frequency and the ratio of low frequency to high frequency (LF/HF)). |
Countries
Spain
Outcome results
None listed