Document Detail

Disrupted right ventricular force-frequency relationships in adults operated for ventricular septal defect as toddlers: Abnormal peak force predicts peak oxygen uptake during exercise.
MedLine Citation:
PMID:  25456699     Owner:  NLM     Status:  Publisher    
Recent studies have shown markedly reduced functional capacity in long-term survivors of ventricular septal defect (VSD), and in order to explore possible mechanisms, we performed non-invasive assessment of ventricular force-frequency relationships during exercise in adults operated for VSD in early childhood. We conducted a prospective study at a tertiary referral center. Patients (n=23) and healthy controls (n=20) underwent continuous Doppler-echocardiographic imaging during supine bicycle ergometry. The cycling workload was individually and manually incremented during the test session in response to heart rate. The heart was imaged in an apical 4-chamber view, and color-coded myocardial velocities were recorded. Post hoc, peak systolic velocity and isovolumetric acceleration (IVA) were blindly determined in the basal ventricular segments. VSD-operated patients differed markedly in all right ventricular endpoints compared with controls. IVA was lower prior to the test, 70±30cm/s(2) vs. 150±60cm/s(2) among controls, and during the entire test session ending at a heart rate of 160beats/min; 140±50cm/s(2) vs. 300±30cm/s(2), p<0.01 at both points. A similar pattern was revealed in terms of peak right ventricular systolic velocity. Left ventricular and septal measurements showed a similar, although less significant, tendency with a clearly lower left ventricular optimum heart rate among patients: 140beats/min vs. 154beats/min among controls. In the diseased cohort biventricular force-frequency relationships were directly correlated to peak oxygen uptake. VSD repair in early childhood is associated with disruption of the right ventricular force-frequency relationship, which may contribute to the previously observed reduction in functional capacity.
Johan Heiberg; Michael Rahbek Schmidt; Andrew Redington; Vibeke Elisabeth Hjortdal
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-28
Journal Detail:
Title:  International journal of cardiology     Volume:  177     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-12-2     Completed Date:  -     Revised Date:  2014-12-3    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  918-924     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
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