Document Detail


Right ventricular performance in the fetus with hypoplastic left heart syndrome.
MedLine Citation:
PMID:  19324154     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In the fetus with hypoplastic left heart syndrome (HLHS), the single right ventricle (RV) pumps the entire cardiac output in utero. By investigating RV performance in utero, we sought to determine the inherent capabilities of a single RV before the increased metabolic demands of postnatal life and surgical palliation. In addition, we sought to determine whether the presence or absence of a left ventricular cavity impacts on RV performance in fetal life. METHODS: Between November 2004 and December 2006, Doppler flow-derived measures of ventricular performance were obtained with echocardiography in 76 fetuses with normal cardiovascular system and in 48 age-matched fetuses with HLHS from 17 weeks until 40 weeks of gestation. The myocardial performance index, ventricular ejection force, and cardiac output were determined for both groups and compared using unpaired Student's t tests and regression analysis. RESULTS: In fetuses with HLHS, cardiac output was diminished by 20%, RV ejection force was elevated, and RV myocardial performance index was elevated compared with those of normal fetuses. The presence of a left ventricular cavity did not impact on RV performance in utero. CONCLUSIONS: Fetuses with HLHS have preserved systolic performance but impaired diastolic performance compared with normal fetuses. The heart of a fetus with HLHS is less efficient than the normal heart in that ejection force of the RV is increased, but overall delivery of cardiac output is lower than normal. We conclude that patients with HLHS have inherent limitations in cardiac performance even before birth.
Authors:
Anita Szwast; Zhiyun Tian; Margaret McCann; Denise Donaghue; Jack Rychik
Related Documents :
6691694 - Cardiac output after burn injury.
11228854 - Cardiac output-based versus empirically programmed av interval--how different are they?
9154744 - Delayed cardiac tamponade following a stab wound: a case report.
15756084 - Delayed pericardial tamponade after penetrating chest trauma.
16487854 - Cardioprotective effects of granulocyte colony-stimulating factor in swine with chronic...
8544674 - Comparison of "accelerated" tissue plasminogen activator with streptokinase for treatme...
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  87     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-27     Completed Date:  2009-04-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1214-9     Citation Subset:  AIM; IM    
Affiliation:
The Fetal Heart Program, Cardiac Center, Children's Hospital of Philadelphia, Pennsylvania 19104, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Cross-Sectional Studies
Echocardiography, Doppler
Female
Fetal Diseases / ultrasonography*
Humans
Hypoplastic Left Heart Syndrome / ultrasonography*
Pregnancy
Retrospective Studies
Ultrasonography, Prenatal
Ventricular Dysfunction, Right / ultrasonography*
Grant Support
ID/Acronym/Agency:
T32-HL007915/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Ann Thorac Surg. 2009 Apr;87(4):1219   [PMID:  19324155 ]

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


Previous Document:  Multidose cold oxygenated blood is superior to a single dose of Bretschneider HTK-cardioplegia in th...
Next Document:  Surgical treatment of anomalies with discontinuity between the right ventricle and the pulmonary art...