Document Detail

Left ventricular diastolic function in children and young adults with congenital aortic valve disease.
MedLine Citation:
PMID:  23102884     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-10-24
Journal Detail:
Title:  The American journal of cardiology     Volume:  111     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-07     Completed Date:  2013-02-26     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  243-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
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MeSH Terms
Aortic Valve / physiopathology
Blood Flow Velocity
Disease Progression
Echocardiography, Doppler
Follow-Up Studies
Heart Defects, Congenital / complications,  physiopathology
Heart Valve Diseases / complications,  congenital*,  physiopathology
Heart Ventricles / physiopathology*,  ultrasonography
Massachusetts / epidemiology
Retrospective Studies
Risk Factors
Ventricular Dysfunction, Left / epidemiology*,  etiology,  physiopathology
Ventricular Function, Left / physiology*
Ventricular Remodeling / physiology*
Young Adult
Grant Support
T32 HL 007572-28/HL/NHLBI NIH HHS; T32 HL007572/HL/NHLBI NIH HHS

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