Heart failure therapy in congenitally corrected transposition of the great arteries: effect on right ventricular function and survival
Authors' conclusion
GDMT use was associated with improved outcomes in patients with moderate/severe RV systolic dysfunction.
Study context
- Population
- Adults with congenitally corrected transposition of the great arteries (cc-TGA) presenting with systemic right ventricular (RV) systolic dysfunction
- Participants
- 213 patients
- Comparison
- Higher baseline guideline-directed medical therapy (GDMT) score and ΔGDMT score
- Outcome
- Improved RV systolic function (relative increase in RVFWS of >20%)
- Follow-up
- 1-year follow-up
Methodological detailsassessed at baseline and 1-year follow-up
- Assessed at baseline and 1-year follow-up
Main finding
As reported in the abstract
Patients with improved RV systolic function
25%
Further findings
Improved neurohormonal activation (relative decrease in NT-proBNP levels of >20%) · 1-year follow-up
- Patients with improved neurohormonal activation
- 56%
- Higher baseline GDMT score and ΔGDMT score were associated with improvement in neurohormonal activation
Mortality
- Patients who died
- 34 (16%)
- Higher baseline GDMT score and ΔGDMT score were associated with a lower risk of mortality
Composite adverse event endpoint (heart failure hospitalization, death, and heart transplantation)
- Higher baseline GDMT score and ΔGDMT score were associated with a lower risk of the composite adverse event endpoint
Baseline and change in GDMT score
- Baseline GDMT score
- 1.97 ± 1.27
- ΔGDMT score (GDMT at 1-year minus GDMT at baseline)
- 0.74 ± 0.39
Baseline RVFWS
- Baseline RVFWS
- −18 ± 5%
Baseline NT-proBNP
- Baseline NT-proBNP
- 369 (142, 1004) pg/mL
Clinical benefits of GDMT use, by severity of RV systolic dysfunction (subgroup)
- Clinical benefits of GDMT use were observed only in patients with moderate/severe RV systolic dysfunction, and not in patients with mild RV systolic dysfunction
Original publication
Heart failure therapy in congenitally corrected transposition of the great arteries: effect on right ventricular function and survival. Eur Heart J. Published 4 November 2026. doi:10.
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