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Effect of medical treatment in patients with systemic right ventricle

Skoglund, Kristofer ; Heimdahl, Joel ; Mandalenakis, Zacharias ; Thilén, Ulf LU ; Johansson, Bengt ; Christersson, Christina ; Sörensson, Peder and Dellborg, Mikael (2020) In Scandinavian Cardiovascular Journal 54(5). p.300-305
Abstract

Objective: Congenitally corrected and surgical atrial redirected transposition of the great arteries (TGA) represents states where the morphological right ventricle serves as a systemic ventricle (S-RV). The S-RV is prone to failure, but data on medical treatment on this problem is limited. The purpose of this study was to evaluate the survival in adults with S-RV, with or without heart failure treatment. Design: The SWEDCON registry was used to collect data. All adults with S-RV and minimum follow-up of 1 year were included retrospectively. Medical treatment was defined as taking beta-blockers and/or ACE inhibitors and/or ARBs for more than 50% of the time. Results: We identified 343 patients with S-RV (median age: 21 years). Surgical... (More)

Objective: Congenitally corrected and surgical atrial redirected transposition of the great arteries (TGA) represents states where the morphological right ventricle serves as a systemic ventricle (S-RV). The S-RV is prone to failure, but data on medical treatment on this problem is limited. The purpose of this study was to evaluate the survival in adults with S-RV, with or without heart failure treatment. Design: The SWEDCON registry was used to collect data. All adults with S-RV and minimum follow-up of 1 year were included retrospectively. Medical treatment was defined as taking beta-blockers and/or ACE inhibitors and/or ARBs for more than 50% of the time. Results: We identified 343 patients with S-RV (median age: 21 years). Surgical atrial redirected TGA was present in 58% and congenitally corrected TGA in 42% of patients. The medically treated group (n = 126) had higher rates of impaired S-RV function, use of diuretics, pacemaker and higher NYHA functional class at baseline compared to controls. The proportion of patients with impaired functional class did not change over time in the medically treated group, but increased in controls (21% vs. 30%, p =.015). In Kaplan–Meier analysis, the mean follow-up was 10.3 years, no difference in survival was seen between the groups. Conclusions: Medical treatment may be beneficial in patients with S-RV and impaired functional class and appears to be safe in the long term. The treatment group had equal survival to controls, despite worse baseline characteristics, which might be a result of slower progression of disease in this group.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
heart failure, medical treatment, Systemic right ventricle
in
Scandinavian Cardiovascular Journal
volume
54
issue
5
pages
6 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85083553441
  • pmid:32274953
ISSN
1401-7431
DOI
10.1080/14017431.2020.1751266
language
English
LU publication?
yes
id
4f2a152b-60d1-418f-924a-415646341f78
date added to LUP
2021-01-12 09:48:34
date last changed
2024-04-03 22:52:59
@article{4f2a152b-60d1-418f-924a-415646341f78,
  abstract     = {{<p>Objective: Congenitally corrected and surgical atrial redirected transposition of the great arteries (TGA) represents states where the morphological right ventricle serves as a systemic ventricle (S-RV). The S-RV is prone to failure, but data on medical treatment on this problem is limited. The purpose of this study was to evaluate the survival in adults with S-RV, with or without heart failure treatment. Design: The SWEDCON registry was used to collect data. All adults with S-RV and minimum follow-up of 1 year were included retrospectively. Medical treatment was defined as taking beta-blockers and/or ACE inhibitors and/or ARBs for more than 50% of the time. Results: We identified 343 patients with S-RV (median age: 21 years). Surgical atrial redirected TGA was present in 58% and congenitally corrected TGA in 42% of patients. The medically treated group (n = 126) had higher rates of impaired S-RV function, use of diuretics, pacemaker and higher NYHA functional class at baseline compared to controls. The proportion of patients with impaired functional class did not change over time in the medically treated group, but increased in controls (21% vs. 30%, p =.015). In Kaplan–Meier analysis, the mean follow-up was 10.3 years, no difference in survival was seen between the groups. Conclusions: Medical treatment may be beneficial in patients with S-RV and impaired functional class and appears to be safe in the long term. The treatment group had equal survival to controls, despite worse baseline characteristics, which might be a result of slower progression of disease in this group.</p>}},
  author       = {{Skoglund, Kristofer and Heimdahl, Joel and Mandalenakis, Zacharias and Thilén, Ulf and Johansson, Bengt and Christersson, Christina and Sörensson, Peder and Dellborg, Mikael}},
  issn         = {{1401-7431}},
  keywords     = {{heart failure; medical treatment; Systemic right ventricle}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{5}},
  pages        = {{300--305}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Cardiovascular Journal}},
  title        = {{Effect of medical treatment in patients with systemic right ventricle}},
  url          = {{http://dx.doi.org/10.1080/14017431.2020.1751266}},
  doi          = {{10.1080/14017431.2020.1751266}},
  volume       = {{54}},
  year         = {{2020}},
}