Ventricular-arterial coupling predicts outcomes in adults with a systemic right ventricle

Abstract Background Patients with a systemic right ventricle (SRV) and biventricular circulation experience high incidence of cardiovascular morbidities decreased survival [1]. Non-invasive measures subclinical ventricular dysfunction are needed to appropriately identify patients at increased risk for adverse outcomes. Ventricular-arterial coupling (VAC), the ratio between effective arterial elastance (Ea) end-systolic (Ees), may predict clinical outcomes in SRV [2]. Objectives To assess VAC adults evaluate its correlation Methods Consecutive magnetic resonance (CMR) examinations D-loop transposition great arteries (TGA) after atrial switch operation L-loop TGA performed Boston Children's Hospital 2005 2019 were analyzed. was calculated as Ea/Ees (Ea = mean blood pressure (MBP)/ventricular stroke volume; Ees MBP/end-systolic volume). Global myocardial strain measured by feature tracking analysis on cine steady-state free precession sequences. Cox proportional hazards regression association functional parameters The adjusted age, sex, body mass index. primary outcome defined composite death, arrest, hospitalizations heart failure (HF); secondary arrhythmias; tertiary included other causes (percutaneous or surgical interventions, device implantation, disease). Cumulative study estimated using Kaplan-Meier method. Results One hundred sixty-seven (mean age 32±10 years, 59% men) HF (n=48, 29%) had higher values compared those without (1.4±0.8 vs. 1.1±0.5, p=0.01). Over follow-up 6.5±4.2 15 over 139 (11%) experienced an rate 1.7 per 100 patient-years (95% confidence interval (CI), 1.04–2.85). Higher significantly associated (p trend 0.01, Figure 1). only parameter (hazard (HR) 1.99, 95% CI: 1.06–3.73, p=0.031), (HR 2.33, 1.12–4.82, p=0.023) 1.63, 1.09–2.44, p=0.018) (Table Ejection fraction (EF) not (p>0.05, Table 1) whereas global circumferential radial showed limited endpoint (p=0.004, Conclusions CMR-derived is improve stratification this unique population. Funding Acknowledgement Type funding sources: None.