| Spontaneous regression of left ventricular dilation in children with restrictive ventricular septal defects. | |
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MedLine Citation:
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PMID: 17517237 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To test the hypothesis that left ventricular (LV) dilation associated with pressure-restrictive ventricular septal defect (VSD) often remains stable or regresses spontaneously, calling into question the role of interventional management for such defects. STUDY DESIGN: We analyzed 96 serial echocardiograms from 33 unoperated patients with a moderate-to-large VSD with LV dilation (LV end-diastolic dimension [LVED] z score >2.0) at enrollment who were followed for more than 2 years. Records of 125 surgical patients also were reviewed. Patients were evaluated for evidence of persistent or progressive LV dilation; signs or symptoms of congestive heart failure (CHF), failure to thrive (FTT), or pulmonary hypertension (PAH); as well as acquired ventricular outflow obstruction or aortic regurgitation. LVED z scores at enrollment versus latest follow-up were compared using paired t tests. A random-effects model with random intercept and slope was fitted to account for repeated observations for each patient. RESULTS: Mean age at enrollment was 4.6 +/- 3.2 years, and mean follow-up was 7.8 +/- 4 years (range, 2.8 to 22 years), during which mean LVED z score decreased from 3.0 +/- 0.6 to 1.2 +/- 1.3 (P < .01). LVED z score decreased in 29 of the 33 patients, and decreased to <2 in 26 of these 29 (79%). CONCLUSIONS: Most patients with pressure-restrictive VSD with moderate-to-severe LV dilation without CHF, FTT, or PAH will experience spontaneous resolution of LV dilation and can avoid cardiac surgery or catheter-based intervention. |
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Authors:
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Charles S Kleinman; Mahnaz Tabibian; Thomas J Starc; Daphne T Hsu; Welton M Gersony |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of pediatrics Volume: 150 ISSN: 1097-6833 ISO Abbreviation: J. Pediatr. Publication Date: 2007 Jun |
Date Detail:
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Created Date: 2007-05-22 Completed Date: 2007-06-14 Revised Date: 2007-12-13 |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: United States |
Other Details:
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Languages: eng Pagination: 583-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatrics, Division of Pediatric Cardiology, Columbia University College of Physicians & Surgeons, New York, NY, USA. ck2098@columbia.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Child Child, Preschool Dilatation, Pathologic Heart Septal Defects, Ventricular / pathology*, physiopathology, therapy, ultrasonography Heart Ventricles / pathology* Humans Infant Remission, Spontaneous Stroke Volume Ultrasonography, Doppler Ventricular Pressure |
| Comments/Corrections | |
Comment In:
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J Pediatr. 2007 Jun;150(6):569-70
[PMID:
17517231
]
J Pediatr. 2007 Nov;151(5):554-5 [PMID: 17961709 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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