| The total cavopulmonary connection resistance: a significant impact on single ventricle hemodynamics at rest and exercise. | |
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MedLine Citation:
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PMID: 18931028 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Little is known about the impact of the total cavopulmonary connection (TCPC) on resting and exercise hemodynamics in a single ventricle (SV) circulation. The aim of this study was to elucidate this mechanism using a lumped parameter model of the SV circulation. Pulmonary vascular resistance (1.96+/-0.80 WU) and systemic vascular resistances (18.4+/-7.2 WU) were obtained from catheterization data on 40 patients with a TCPC. TCPC resistances (0.39+/-0.26 WU) were established using computational fluid dynamic simulations conducted on anatomically accurate three-dimensional models reconstructed from MRI (n=16). These parameters were used in a lumped parameter model of the SV circulation to investigate the impact of TCPC resistance on SV hemodynamics under resting and exercise conditions. A biventricular model was used for comparison. For a biventricular circulation, the cardiac output (CO) dependence on TCPC resistance was negligible (sensitivity=-0.064 l.min(-1).WU(-1)) but not for the SV circulation (sensitivity=-0.88 l.min(-1).WU(-1)). The capacity to increase CO with heart rate was also severely reduced for the SV. At a simulated heart rate of 150 beats/min, the SV patient with the highest resistance (1.08 WU) had a significantly lower increase in CO (20.5%) compared with the SV patient with the lowest resistance (50%) and normal circulation (119%). This was due to the increased afterload (+35%) and decreased preload (-12%) associated with the SV circulation. In conclusion, TCPC resistance has a significant impact on resting hemodynamics and the exercise capacity of patients with a SV physiology. |
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Authors:
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Kartik S Sundareswaran; Kerem Pekkan; Lakshmi P Dasi; Kevin Whitehead; Shiva Sharma; Kirk R Kanter; Mark A Fogel; Ajit P Yoganathan |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2008-10-17 |
Journal Detail:
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Title: American journal of physiology. Heart and circulatory physiology Volume: 295 ISSN: 0363-6135 ISO Abbreviation: Am. J. Physiol. Heart Circ. Physiol. Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-12-05 Completed Date: 2009-01-30 Revised Date: 2010-09-21 |
Medline Journal Info:
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Nlm Unique ID: 100901228 Medline TA: Am J Physiol Heart Circ Physiol Country: United States |
Other Details:
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Languages: eng Pagination: H2427-35 Citation Subset: IM |
Affiliation:
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Wallace H. Coulter Department of Biomedical Engineering, School of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332-0535, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Cardiac Output Child Child, Preschool Computer Simulation Databases as Topic Exercise Tolerance* Fontan Procedure* Heart Catheterization Heart Defects, Congenital / pathology, physiopathology*, surgery Heart Rate Hemodynamics* Humans Magnetic Resonance Angiography Magnetic Resonance Imaging, Cine Models, Anatomic Models, Cardiovascular Pulmonary Artery / pathology, physiopathology*, surgery Pulmonary Circulation* Reproducibility of Results Treatment Outcome United States Vascular Resistance Vena Cava, Inferior / pathology, physiopathology*, surgery Vena Cava, Superior / pathology, physiopathology*, surgery Ventricular Function* |
| Grant Support | |
ID/Acronym/Agency:
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HL-67622/HL/NHLBI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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