Your browser doesn't support javascript.
loading
Right ventricular function in patients with pulmonary regurgitation with versus without tetralogy of Fallot.
Larios, Guillermo; Yim, Deane; Dragulescu, Andreea; Mertens, Luc; Grosse-Wortmann, Lars; Friedberg, Mark K.
Afiliação
  • Larios G; Division of Cardiology, Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada; Division of Pediatrics, P. Universidad Catolica de Chile, Santiago, Chile.
  • Yim D; Division of Cardiology, Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada; Division of Pediatric Cardiology, Perth Children´s Hospital, Perth, Australia.
  • Dragulescu A; Division of Cardiology, Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
  • Mertens L; Division of Cardiology, Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
  • Grosse-Wortmann L; Division of Cardiology, Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
  • Friedberg MK; Division of Cardiology, Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada. Electronic address: mark.friedberg@sickkids.ca.
Am Heart J ; 213: 8-17, 2019 07.
Article em En | MEDLINE | ID: mdl-31071505
BACKGROUND: Right ventricular (RV) dilation from pulmonary valve regurgitation (PR) is common after intervention(s) for pulmonary stenosis (PS) or atresia and intact ventricular septum (PA/IVS). It is not well established whether PR and RV dilation have similar effects on RV function and exercise capacity in these patients compared to patients after repair of tetralogy of Fallot (rToF). The aims of this study were to compare exercise tolerance, RV function and myocardial mechanics in non-ToF versus rToF children with significantly increased and comparable RV volumes. METHODS: Thirty PS or PA/IVS children after intervention(s) with significant PR and RV dilation (non-ToF group) were retrospectively matched for RV end-diastolic volume index (RVEDVi) and age with 30 rToF patients. Clinical characteristics, RV function by echocardiography and CMR, ECG and exercise capacity were compared between groups. RESULTS: The groups were well matched for RVEDVi and age. Global RV function (RVEF: 48.7 ±â€¯6.4% vs. 48.5 ±â€¯7.2%, P = .81) and exercise capacity (% predicted peak VO2:82.5 ±â€¯17.7% vs. 75.6 ±â€¯20.4%, P = .27) were similarly reduced between groups. RVEDVi correlated inversely with RVEF in both groups (non-ToF:r = -0.39, P = .04, rToF:r = -0.40, P = .03). QRS duration was wider in rToF patients, and in both groups inversely correlated with RVEF (non-ToF:r = -0.77, P < .001, rToF:r = -0.69, P < .001). In contrast to global function, longitudinal RV strain was lower in rTOF vs non-TOF (-20.1 ±â€¯3.9 vs.-25.7 ±â€¯4.4, P < .001). CONCLUSIONS: Global RV function and exercise capacity are similarly reduced in non-ToF and rToF patients with severely dilated RV, after matching by RVEDVi, suggesting a comparable impact of RV dilation on RV global function. The significance of reduced RV longitudinal function and worse dyssynchrony in rToF patients require further exploration.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência da Valva Pulmonar / Estenose da Valva Pulmonar / Tetralogia de Fallot / Função Ventricular Direita / Hipertrofia Ventricular Direita / Tolerância ao Exercício Tipo de estudo: Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Am Heart J Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Chile País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência da Valva Pulmonar / Estenose da Valva Pulmonar / Tetralogia de Fallot / Função Ventricular Direita / Hipertrofia Ventricular Direita / Tolerância ao Exercício Tipo de estudo: Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Am Heart J Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Chile País de publicação: Estados Unidos