Document Detail


Mechanisms for cardiac output augmentation in patients with a systemic right ventricle.
MedLine Citation:
PMID:  19237212     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Conflicting data have been published on the differences in cardiac response to exercise between patients with an atrially switched transposition of the great arteries (TGA), and patients with a congenitally corrected TGA (ccTGA). The purpose of our study was to evaluate the differences in cardiac response to exercise in these 2 patient groups with a systemic right ventricle (RV).
METHODS: Thirty four patients (62% male; mean 35, range 21-69 years) with a systemic RV (20 with an atrially switched TGA and 14 with a ccTGA) were included. Exercise tests with Portapres measurements were performed to assess maximal exercise capacity (V'O(2peak)), cardiac index, stroke volume index, and heart rate augmentation. Cardiac function was assessed by Cardiovascular Magnetic Resonance or Computed Tomography, and serum NT-proBNP levels.
RESULTS: We found that both groups were able to significantly augment cardiac index during exercise. Cardiac index augmentation during exercise was positively related to V'O(2peak) (r=0.37, p<0.05), and independent of resting cardiac function. Although the increase in cardiac index during exercise was similar in both patients with TGA and with ccTGA, mechanisms to achieve this increase differed between groups. ccTGA patients increased both stroke volume and heart rate during exercise. Atrially switched TGA patients augmented heart rate during exercise, but failed to increase stroke volume.
CONCLUSION: Mechanisms to achieve cardiac output augmentation differ between ccTGA patients and TGA patients. We suggest that therapeutic approaches should be tailored to the specific patient group to avoid counterproductive effects.
Authors:
Michiel M Winter; Mart N van der Plas; Berto J Bouma; Maarten Groenink; Paul Bresser; Barbara J M Mulder
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-02-23
Journal Detail:
Title:  International journal of cardiology     Volume:  143     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  141-6     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Exercise / physiology*
Female
Heart Function Tests
Heart Rate / physiology
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Stroke Volume / physiology*
Tomography, X-Ray Computed
Transposition of Great Vessels / physiopathology*,  surgery*
Ventricular Dysfunction, Right / diagnosis,  physiopathology*
Young Adult

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


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