| Restrictive right ventricular physiology: its presence and symptomatic contribution in patients with pulmonary valvular stenosis. | |
| | |
MedLine Citation:
|
PMID: 17919570 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: The aim of this study was to examine whether restrictive right ventricular (RV) physiology (the presence of antegrade pulmonary arterial flow in late diastole) occurred in patients with moderate to severe isolated pulmonary valvular stenosis (PVS) and to estimate its prevalence and relationship to RV function and patient symptoms. BACKGROUND: Little is published about RV diastolic performance in adult patients with PVS. METHODS: A total of 43 consecutive patients (age 44 +/- 10 years) with moderate to severe PVS referred to Royal Brompton Hospital from 2002 to 2005 were retrospectively studied. Patient New York Heart Association (NYHA) functional class was recorded. The RV (lateral tricuspid annulus motion) long-axis movement was measured by M-mode and pulsed-wave (PW) tissue Doppler imaging (TDI). Restrictive RV physiology was assessed by PW Doppler echocardiography. RESULTS: Eighteen patients (42%) had restrictive RV physiology. They were more symptomatic (NYHA functional class 1.8 +/- 0.5 vs. 1.3 +/- 0.5; p < 0.001) and had poorer RV long-axis function (TDI peak systolic velocity 7.3 +/- 2.1 cm/s vs. 9.7 +/- 2.7 cm/s; TDI early diastolic velocity 6.6 +/- 1.6 cm/s vs. 8.5 +/- 2.4 cm/s; RV long-axis systolic amplitude 1.3 +/- 0.2 cm vs. 1.5 +/- 0.3 cm; p < 0.01 for all) compared with other PVS patients despite similar RV ejection fraction, myocardial performance index, and RV systolic pressure. The presence of restrictive RV physiology (odds ratio [OR] 6.05, 95% confidence interval [CI] 1.45 to 10.29; p = 0.01) and peak pulmonary valve pressure gradient (OR 1.07, 95% CI 1.01 to 1.13; p = 0.04) were the 2 independent echocardiographic predictors for decreased exercise tolerance in patients on multivariate analysis. CONCLUSIONS: Restrictive RV physiology is common in PVS patients. Its presence is related to a worse deterioration in RV long-axis function and decreased exercise tolerance in patients. |
| | |
Authors:
|
Yat-Yin Lam; Mehmet G Kaya; Omer Goktekin; Michael A Gatzoulis; Wei Li; Michael Y Henein |
Publication Detail:
|
Type: Journal Article Date: 2007-09-24 |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 50 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2007 Oct |
Date Detail:
|
Created Date: 2007-10-08 Completed Date: 2007-10-26 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 1491-7 Citation Subset: AIM; IM |
Affiliation:
|
Adult Congenital Heart Unit, Royal Brompton Hospital, London, United Kingdom. homalam@hotmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Comorbidity Echocardiography, Doppler Exercise Tolerance Female Humans Male Middle Aged Pulmonary Artery / physiopathology Pulmonary Valve Stenosis / epidemiology, physiopathology*, ultrasonography Regional Blood Flow Retrospective Studies Stroke Volume Ventricular Dysfunction, Right / epidemiology, physiopathology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Diminished left ventricular dyssynchrony and impact of resynchronization in failing hearts with righ...
Next Document: Risk factors for reoperation after repair of discrete subaortic stenosis in children.