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Post-operative troponin levels and left ventricular function in patients with d-transposition of the great arteries following the arterial switch operation

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Abstract

The aim of this study was to assess the significance of post-operative troponin levels as a surrogate for left ventricular (LV) dysfunction measured by global longitudinal strain (GLS) in patients with dextro-transposition of the great arteries (d-TGA) who undergo an arterial switch operation (ASO), and to explore the LV GLS recovery in the mid-term follow-up period. Seventy-eight neonates were included, of whom 41 had troponin-I measurements and 37 had troponin-T measurements. The primary outcome of LV GLS was assessed and compared with healthy controls at the pre-operative stage and time of discharge, 3 months, 6 months and 12 months of age. Secondary outcomes included deaths or transplantations and other clinical markers such as length of hospital stay. D-TGA patients had worse LV GLS post-operatively compared to age-matched controls (p < 0.01) which improved by 12 months of age (p = 0.53). No association was found between changes in troponin-I or troponin-T levels and LV GLS at the time of discharge (r = 0.4, p = 0.64 and r = -0.5, p = 0.91, respectively). In addition, there were no deaths or transplantations in this cohort over a period of 12 months. LV GLS appears to worsen in the early post-operative period for d-TGA patients who undergo neonatal ASO but this recovers through the first post-operative year. Troponin levels have limited value in predicting early or midterm LV dysfunction and recovery.

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Abbreviations

d-TGA:

Dextro-transposition of the great arteries

ASO:

Arterial switch operation

LV:

Left ventricle

GLS:

Global longitudinal strain

VSD:

Ventricular septal defects

LOS:

Length of stay

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The authors declare that no funds, grants or other support were received.

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Authors and Affiliations

  1. Division of Pediatric Cardiology, NewYork-Presbyterian-Morgan Stanley Children’s Hospital/Columbia University Irving Medical Center, 3959 Broadway, CHN 2, New York, NY, 10032, USA

    Sanghee S. Ro, Nikhil Pasumarti, Amee Shah, Tarif A. Choudhury, Brett R. Anderson & Michael P. DiLorenzo

  2. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA

    Qinxia Wan

  3. Division of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Kravis Children’s Hospital, New York, NY, USA

    Jenna Keelan

  4. Division of Neonatology, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA

    Ganga Krishnamurthy

  5. Department of Cardiothoracic, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA

    Damien LaPar & Emile Bacha

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by SSR, QW, and NP. The first draft of the manuscript was written by SSR and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Sanghee S. Ro.

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Ro, S.S., Wan, Q., Pasumarti, N. et al. Post-operative troponin levels and left ventricular function in patients with d-transposition of the great arteries following the arterial switch operation. Int J Cardiovasc Imaging 39, 97–111 (2023). https://doi.org/10.1007/s10554-022-02714-9

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