Recoupling of right and left ventricle pump function after surgical ventricle restoration : a cardiac magnetic resonance study

To evaluate biventricular pump function after surgical ventricle restoration (SVR) using cardiac magnetic resonance (CMR). We retrospectively studied 39 patients who performed 1.5-T CMR before/after SVR acquiring short-axis ECG-gated cine sequences. End-diastolic, end-systolic, and stroke volume indexed to body surface area (EDVI, ESVI, and SVI), ejection fraction (EF), and their modification after SVR (∆) were obtained for right ventricle (RV) and left ventricle (LV). Wilcoxon signed rank test and Spearman correlation coefficient were used; EF reproducibility was estimated. Median LVEF increased from 24 % [interquartile range (IQR) 19–31 %] before SVR to 34 % (IQR 29–43 %) after SVR (P < 0.001). Median RVEF remained unchanged from 58 % (IQR 48–66 %) before SVR to 57 % (IR 46–64 %) after SVR (P = 0.743). The correlation between LVEF and RVEF was not significant before SVR (r = 0.182; P = 0.266) but significant after SVR (r = 0.445; P = 0.005). The ∆RVEF was positively correlated with ∆LVEF (r = 0.558; P < 0.001). ∆RVSVI was positively correlated with ∆LVSVI (r = 0.502; P = 0.001). LVEF reproducibility before SVR was 97 % for both intra- and inter-reader reproducibility; RVEF reproducibility was 96 and 93 %, respectively. SVR improved LV function without apparent impact on RV function. After SVR the two ventricles showed a functional recoupling. Reproducibility of CMR EF was excellent for both ventricles.