Objective To test the hypothesis that ventricular and atrial function are different between patients with transposition of the great arteries (TGA) after arterial switch operation (ASO) and healthy controls. Methods 103 consecutive patients with TGA (median age: 16.7 years, 4.3–39.6 years, 71.8% male) were compared with 77 controls (median age: 15.4 years, 6.3–43.2 years, 66.2% male). Biventricular and biatrial function were assessed using standard cardiovascular magnetic resonance (CMR) techniques and feature tracking. Group comparison was performed with conventional non-parametrical statistics and machine learning methods to find the variables most discriminative between patients and controls. These variables were used to build a multivariable logistic regression model to assess the case–control status. Results Markers of left and right ventricular function (LV; RV) (ejection fraction, MAPSE, TAPSE, LV long-axis strain) as well as LV global longitudinal (−20.7 (−24.1; −17.9) vs −23.7 (−26.1; −21.6), p<0.001), circumferential (−29.4 (−32.2; −26.5) vs −30.5 (−33.6; 29), p=0.001) and atrial longitudinal strain (left atrium (LA): 23.3 (18.6; 28.8) vs 36.7 (30.7; 44), p<0001; right atrium: 21.7 (18.2; 27.8) vs 34.9 (26.9; 40.3), p<0.001) were reduced in patients compared with controls using non-parametrical testing. The logistic regression model including the most discriminative variables from univariate and machine learning analysis demonstrated significant differences between patients and controls only for TAPSE and LA global longitudinal strain. Conclusions Biventricular and biatrial function are largely preserved after ASO for TGA. Using a comprehensive CMR protocol along with statistical machine learning methods and a regression approach, only RV longitudinal function and LA function are significantly impaired. Data are available on reasonable request.

中文翻译：

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动脉转换手术后心房和心房功能和变形基本保留

目的检验动脉转换手术（ASO）后大动脉转位（TGA）患者与健康对照组心室和心房功能不同的假设。方法 将 103 名连续 TGA 患者（中位年龄：16.7 岁，4.3-39.6 岁，71.8% 男性）与 77 名对照组（中位年龄：15.4 岁，6.3-43.2 岁，66.2% 男性）进行比较。使用标准心血管磁共振 (CMR) 技术和特征跟踪评估双心室和双心房功能。使用传统的非参数统计和机器学习方法进行组比较，以找到最能区分患者和对照的变量。这些变量用于构建多变量逻辑回归模型以评估病例对照状态。结果 左右心室功能 (LV; RV)（射血分数、MAPSE、TAPSE、LV 长轴应变）以及 LV 整体纵向（-20.7 (-24.1; -17.9) vs -23.7 (-26.1; -21.6), p<0.001), 周向 (-29.4 (-32.2; -26.5) vs -30.5 (-33.6; 29), p=0.001) 和心房纵向应变（左心房 (LA): 23.3 (18.6; 28.8) ) vs 36.7 (30.7; 44), p<0001; 右心房：21.7 (18.2; 27.8) vs 34.9 (26.9; 40.3), p<0.001) 与对照组相比，使用非参数检验的患者减少。逻辑回归模型包括来自单变量和机器学习分析的最具辨别力的变量，仅在 TAPSE 和 LA 全局纵向应变方面显示患者和对照之间存在显着差异。结论 TGA ASO 后双心室和双心房功能在很大程度上得以保留。使用全面的 CMR 协议以及统计机器学习方法和回归方法，只有 RV 纵向功能和 LA 功能显着受损。可应合理要求提供数据。