Haemodynamics and Function of the Atria in Congenital Heart Disease by Cardiovascular Magnetic Resonance

Study Overview
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Brief Summary
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The purpose of this study is to determine whether patients with repaired congenital heart disease show differences in size or function of their heart atria compared to normal controls and depending on the nature of their heart disease.

Detailed Description
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Atrial function is important for good ventricular filling and function. In patients with impaired cardiac function, atrial contraction is even more important. So far, the size and function of the atria have been assessed two-dimensionally by angiography and by echocardiography. However, these do not allow exact characterization of the volumetric changes of the atria during the cardiac cycle. Recently, cardiac magnetic resonance (CMR) has been used to assess size and function of the left atrium in adults. Little data are available about function and volume of the atria in children and the role of the atria in congenital heart disease (CHD). The study will recruit patients with CHD (n=40) and normal controls (n=10). The patient group will be composed by patients suffering from the following conditions: coarctation of the aorta (n=10), tetralogy of Fallot (n=10), transposition of the great arteries after atrial switch (Senning procedure) (n=10), transposition of the great arteries after arterial switch operation (n=10). The study consists of measurements of sizes and function of the right and the left atrium, respectively, by examining three-dimensional volume changes across the heart cycle, and of phase contrast measurements of blood flow across the valves of the heart.

Official Title
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Haemodynamics and Function of the Atria in Patients With Congenital Heart Defects - Pilot Study by Cardiovascular Magnetic Resonance

Conditions
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Coarctation of the Aorta, Tetralogy of Fallot, Transposition of the Great Arteries

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ability to perform repetitive breath holds of 10-15 seconds each Written informed consent of the patients or their legal guardians Exclusion Criteria: Patients requiring general anaesthesia Residual cardiac findings which might potentially influence the size and function of the atria

Ages Eligible for Study
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Minimum Age: 8 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Aortic coarctation<br>Patients after repair of coarctation of the aorta | |
| Tetralogy of Fallot<br>Patients after repair of tetralogy of Fallot | |
| TGA atrial switch<br>Patients with transposition of the great arteries after atrial switch (Senning procedure) | |
| TGA arterial switch<br>Patients with transposition of the great arteries after arterial switch operation | |
| Normal<br>Normal controls | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Right and left atrial volume | Measurement of maximal volume (at end of systole), volume before atrial contraction (in late diastole), and minimal volume (at end of diastole) of both atria. | Day of CMR (baseline only, no intervention) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood flow across the atrio-ventricular valves | Phase contrast measurement of blood flow across the atrio-ventricular and the ventriculo-arterial valves, respectively, to serve as an internal validation of total atrial emptying volumes, as well as to contribute maximum early and late diastolic velocities. | Day of CMR (baseline only, no intervention) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Coarctation of the Aorta, Atria, Heart, Function, Atrial, Heart Defects, Congenital, Cardiovascular Abnormalities, Congenital Abnormalities, Tetralogy, Fallot, Transposition of Great Arteries