Document Detail


Restrictive right ventricular physiology and right ventricular fibrosis as assessed by cardiac magnetic resonance and exercise capacity after biventricular repair of pulmonary atresia and intact ventricular septum.
MedLine Citation:
PMID:  20186992     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The hypertrophic myocardium, myocardial fiber disarray, and endocardial fibroelastosis in pulmonary atresia and intact ventricular septum (PAIVS) may provide anatomic substrates for restrictive filling of the right ventricle. HYPOTHESIS: Restrictive right ventricle (RV) physiology is related to RV fibrosis and exercise capacity in patients after biventricular repair of PAIVS. METHODS: A total of 27 patients, age 16.5 +/- 5.6 years, were recruited after biventricular repair of PAIVS. Restrictive RV physiology was defined by the presence of antegrade diastolic pulmonary flow and RV fibrosis assessed by late gadolinium enhancement (LGE) cardiac magnetic resonance. Their RV function was compared with that of 27 healthy controls and related to RV LGE score and exercise capacity. RESULTS: Compared with controls, PAIVS patients had lower tricuspid annular systolic and early diastolic velocities, RV global longitudinal systolic strain, systolic strain rate, and early and late diastolic strain rates (all P < 0.05). A total of 22 (81%, 95% confidence interval: 62%-94%) PAIVS patients demonstrated restrictive RV physiology. Compared to those without restrictive RV physiology (n = 5), these 22 patients had lower RV global systolic strain, lower RV systolic and early diastolic strain rates, higher RV LGE score, and a greater percent of predicted maximum oxygen consumption (all P < 0.05). CONCLUSION: Restrictive RV physiology reflects RV diastolic dysfunction and is associated with more severe RV fibrosis but better exercise capacity in patients after biventricular repair of PAIVS.
Authors:
Xue-Cun Liang; W W M Lam; E W Y Cheung; A K P Wu; Sophia J Wong; Yiu-Fai Cheung
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  33     ISSN:  1932-8737     ISO Abbreviation:  Clin Cardiol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  104-10     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Wiley Periodicals, Inc.
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Balloon Dilatation
Cardiac Surgical Procedures* / adverse effects
Cardiomyopathy, Restrictive / diagnosis*,  etiology,  physiopathology
Case-Control Studies
Contrast Media / diagnostic use
Echocardiography, Doppler
Exercise Test*
Exercise Tolerance*
Female
Fibrosis
Gadolinium DTPA / diagnostic use
Heart Ventricles / pathology,  physiopathology
Humans
Magnetic Resonance Imaging*
Male
Oxygen Consumption
Predictive Value of Tests
Pulmonary Atresia / complications,  diagnosis,  physiopathology,  surgery*
Pulmonary Circulation
Severity of Illness Index
Treatment Outcome
Ventricular Dysfunction, Right / diagnosis*,  etiology,  physiopathology
Ventricular Function, Right*
Young Adult
Chemical
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA

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


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