| Left ventricular diastolic function in children and young adults with congenital aortic valve disease. | |
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MedLine Citation:
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PMID: 23102884 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Young patients with congenital aortic valve disease are at risk of left ventricular (LV) diastolic dysfunction (DD). We evaluated LV remodeling and the prevalence of, and risk factors for, DD in patients with aortic stenosis (AS), pure aortic regurgitation (AR), and AS+AR. Patients aged 8 to 39 years with congenital AS (n = 103), AR (n = 36), or AS+AR (n = 107) were identified. Cross-sectional assessment of the LV remodeling pattern and diastolic function was performed. A diastolic function score (DFS; range 0 to 4) was assigned to each patient, with 1 point for an abnormal value in each of 4 categories: mitral inflow (E/A and E-wave deceleration time), tissue Doppler E', E/E', and left atrial volume. Patients with a DFS of ≥2 were compared to those with a DFS <2. Concentric hypertrophy was the most common remodeling pattern in those with AS (51%), mixed/physiologic hypertrophy in those with AS+AR (48%) and eccentric hypertrophy in those with AR (49%) predominated. In the entire cohort, 91 patients (37%) had a DFS of ≥2. Patients with AS or AS+AR had greater DFS than those with pure AR (p <0.001). On multivariate analysis, a greater LV mass z-score and previous aortic valve balloon dilation were associated with a DFS of ≥2. In patients with catheterization data (n = 65), E/E' correlated with LV end-diastolic pressure. Those with a DFS of ≥2 had a greater LV end-diastolic pressure and mean pulmonary artery pressure than those with a DFS <2. In conclusion, DD is common in young patients with AS and AS+AR but not in those with pure AR. A greater LV mass and previous aortic valve dilation were associated with DD. |
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Authors:
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Kevin G Friedman; Doff B McElhinney; Jonathan Rhodes; Andrew J Powell; Steven D Colan; James E Lock; David W Brown |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural Date: 2012-10-24 |
Journal Detail:
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Title: The American journal of cardiology Volume: 111 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-01-07 Completed Date: 2013-02-26 Revised Date: 2013-04-16 |
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: 243-9 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2013 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiology, Children's Hospital Boston and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA. Kevin.Friedman@cardio.chboston.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aortic Valve / physiopathology Blood Flow Velocity Child Diastole Disease Progression Echocardiography, Doppler Female Follow-Up Studies Heart Defects, Congenital / complications, physiopathology Heart Valve Diseases / complications, congenital*, physiopathology Heart Ventricles / physiopathology*, ultrasonography Humans Incidence Male Massachusetts / epidemiology Prognosis Retrospective Studies Risk Factors Ventricular Dysfunction, Left / epidemiology*, etiology, physiopathology Ventricular Function, Left / physiology* Ventricular Remodeling / physiology* Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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T32 HL 007572-28/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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