Inflammation and echocardiographic ventricular function in patients with a systemic right ventricle and heart failure

Abstract Background Clinical deterioration is fast once heart failure (HF) develops in patients with a systemic right ventricle (sRV) [1]. Despite its established role HF normal anatomy [2,3], little known about the contribution of inflammation sRV-HF patients. Aims To assess and echocardiography sRV or without to relate echocardiographic ventricular function. Methods In this cross-sectional prospective study, due Senning/Mustard repair congenitally corrected transposition great arteries (ccTGA) were consecutively enrolled at outpatient clinic single, tertiary care center. Echocardiography venipuncture performed on same day. C-reactive protein (CRP), red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), myeloperoxidase (MPO), citrullinated histone H3-DNA complexes (MPO-DNA H3Cit-DNA) interleukin 10 measured. Patients stratified based presence absence HF, defined as having signs and/or symptoms requiring medical therapy plus one following: impaired function elevated intracardiac pressures, N-terminal pro-brain natriuretic peptide, peak oxygen consumption lowest quartile (according published norms for TGA patients). Comparative statistics univariate correlations performed. Results Eighty-seven included (mean age 39 years; 69% male; 25% ccTGA, 68% NYHA class I) from which third (29/87) had HF. Most inflammatory markers significantly higher group compared non-HF: CRP (4.3 vs 2.21 mg/dL; P=0.016), RDW (13.6 12.7 fL; P<0.001), NLR (3.6 2.9; P=0.01), MPO (171 139 ng/mL; P=0.03) MPO-DNA (1.4 1.2; P=0.04). When assessing systolic function, had: i) lower strain free wall (10.9 13.1%; P=0.008), ii) mitral annular plane excursion (MAPSE) (1.7 2.1 cm; P<0.001) iii) rate (SR) subpulmonary LV (spLV) (1.0 1.3 S-1; P=0.03). The spLV was also more hypertrophied (end-diastolic posterior 0.99 0.79 P=0.007) dilated internal diameter 4.1 3.3 P=0.006) showed strongest (Spearman correlation coefficient r>0.29) RV correlated lateral tricuspid velocity (r=−0.313**), (r=−0.317**) global longitudinal (r=−0.292**) sRV. MAPSE (r=−0.313**). **P<0.01. Conclusions have strain. With remodeling SR spLV, cannot be ignored when evaluating Correlation between however, limited. Funding Acknowledgement Type funding sources: Public grant(s) – National budget only. Main source(s): ERA-CVD JTC2019 (Fonds Wetenschappelijk Onderzoek G0G1719N K.M. A.V.D.B); German Bundesministerium für Bildung und Forschung 01KL2001 T.W.)