Document Detail


Effects of coil closure of patent ductus arteriosus on left anterior descending coronary artery blood flow using transthoracic Doppler echocardiography.
MedLine Citation:
PMID:  15163939     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Transthoracic Doppler echocardiography provides noninvasive measurements of coronary blood flow in the left anterior descending coronary artery (LAD). This method has the potential to show the effects of acute changes in loading conditions on blood flow. Coil closure of patent ductus arteriosus (PDA) is a model of acute changes in blood pressure and left ventricular (LV) preload that influences coronary blood flow. We applied this technique to assess the coronary blood flow changes for patients with PDA before and immediately after PDA coil closure. We examined 9 patients (1.8 +/- 1.1 years) with simple PDA and 8 age-matched healthy children. LV dimensions and LV mass were measured. Maximum peak flow velocity and flow volume in the LAD were measured. Pulmonary to systemic flow ratios (Qp/Qs) were obtained by cardiac catheterization. After PDA coil closure, LV end-diastolic dimension decreased, and systolic and diastolic blood pressures increased significantly. The maximum peak flow velocity, LAD flow volume, and the ratio of LAD flow volume to LV mass increased significantly. The changes in maximum peak flow velocity and the ratio of LAD flow volume to LV mass (F/M) correlated positively with the changes in diastolic pressure and Qp/Qs. In 5 patients who had Qp/Qs > 1.5, the mean F/M was significantly lower compared with control subjects, but they increased to normal values after coil closure of PDA. PDA coil closure increases diastolic pressure and decreases Qp/Qs, resulting in improvement of myocardial perfusion. These findings provide new insights into the relationship between cardiac function and coronary circulation in pediatric patients with heart diseases associated with PDA.
Authors:
Kenji Harada; Manotomo Toyono; Masamichi Tamura
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  17     ISSN:  0894-7317     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-05-27     Completed Date:  2004-09-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  659-63     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Ajkita University School of Medicine, Japan. kharada@doc.med.akita-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Blood Circulation / physiology
Blood Flow Velocity / physiology
Blood Pressure / physiology
Blood Volume / physiology
Case-Control Studies
Coronary Circulation / physiology*
Coronary Vessels / physiopathology*,  ultrasonography
Diastole
Ductus Arteriosus, Patent / physiopathology,  therapy*
Echocardiography, Doppler*
Embolization, Therapeutic / instrumentation*
Follow-Up Studies
Heart Ventricles / ultrasonography
Humans
Infant
Prospective Studies
Pulmonary Circulation / physiology
Stroke Volume / physiology
Systole
Ventricular Function, Left / physiology
Ventricular Pressure / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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