| Application of classic heart failure definitions of asymptomatic and symptomatic ventricular dysfunction and heart failure symptoms with preserved ejection fraction to patients with systemic right ventricles. | |
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MedLine Citation:
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PMID: 19616677 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Heart failure guidelines classify patients into subgroups with asymptomatic versus symptomatic ventricular dysfunction versus heart failure with a preserved ejection fraction. In this study, this approach was applied in a series of patients with complete transposition of the great arteries after atrial switch to assess to what extent this classification fits patients with systemic right ventricles. The study included stable adult patients after atrial switch, stratified according to preserved versus impaired systolic function (fractional area change > or =0.40 vs <0.40), absence versus presence of symptoms, absence versus presence of significant tricuspid regurgitation (TR), and normal versus elevated brain natriuretic peptide (BNP) levels. Twenty-two of 42 participants (52.4%; mean age 18.2 +/- 2.8 years) had preserved systolic function, and 20 (47.6%) had impaired systolic function; 10 patients (23.8%) had asymptomatic right ventricular (RV) dysfunction. The latter more frequently had significant TR (p = 0.04) and elevated BNP levels (p = 0.008), compared with asymptomatic patients with preserved systolic function. Normal BNP levels independently predicted preserved RV function in all patients (odds ratio 6.4, 95% confidence interval 1.03 to 39.1, p = 0.04) and in asymptomatic patients (odds ratio 14.4, 95% confidence interval 1.2 to 176.2, p = 0.03). Heart failure symptoms with preserved systolic function were present in 5 patients (11.9%), including 3 patients with significant TR. In conclusion, asymptomatic RV dysfunction and heart failure symptoms with preserved systolic function are common in patients with systemic right ventricles. BNP levels can be used to predict preserved systolic RV function, especially in asymptomatic patients. Heart failure symptoms with preserved RV systolic function can be frequently explained by the coexistence of significant TR. |
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Authors:
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Piotr Szymański; Anna Klisiewicz; Barbara Lubiszewska; Magdalena Lipczyńska; Piotr Michałek; Jadwiga Janas; Piotr Hoffman |
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Publication Detail:
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Type: Journal Article Date: 2009-06-06 |
Journal Detail:
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Title: The American journal of cardiology Volume: 104 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-20 Completed Date: 2009-08-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 414-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Adult Congenital Heart Disease, Institute of Cardiology, Warsaw, Poland. p.szymanski@ikard.pl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Female Heart Failure / classification*, etiology, physiopathology* Humans Male Risk Assessment Severity of Illness Index Stroke Volume Systole Transposition of Great Vessels / complications, surgery Tricuspid Valve Insufficiency / physiopathology* Ventricular Dysfunction, Right / physiopathology* Ventricular Function, Right / physiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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