Effect of electrical dyssynchrony on left and right ventricular mechanics in children with pulmonary arterial hypertension

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
Michal SchäferJohannes C von Alvensleben

Abstract

Electrical and right ventricular (RV) mechanical dyssynchrony has been previously described in pediatric pulmonary arterial hypertension (PAH), but less is known about the relationship between electrical dyssynchrony and biventricular function. In this study we applied cardiac magnetic resonance (CMR) imaging to evaluate biventricular size and function with a focus on left ventricular (LV) strain mechanics in pediatric PAH patients with and without electrical dyssynchrony. Fifty-six children with PAH and comprehensive CMR evaluation were stratified based on QRS duration z-score, with electrical dyssynchrony defined as z-score ≥2. Comprehensive biventricular volumetric, dyssynchrony, and strain analysis was performed. Nineteen PAH patients had or developed electrical dyssynchrony. Patients with electrical dyssynchrony had significantly reduced RV ejection fraction (35% vs 50%, p = 0.003) and greater end-diastolic (168 vs 112 ml/m2, p = 0.041) and end-systolic (119 vs 57, ml/m2, p = 0.026) volumes. Patients with electrical dyssynchrony had reduced RV longitudinal strain (-14% vs -19%, p = 0.007), LV circumferential strain measured at the free wall (-19% vs -22%, p = 0.047), and the LV longitudinal strain in the septal region (-10...Continue Reading

Citations

Aug 25, 2018·Expert Review of Respiratory Medicine·Roberto BadagliaccaCarmine Dario Vizza
Dec 21, 2019·American Journal of Physiology. Heart and Circulatory Physiology·Benjamin S FrankJohannes C von Alvensleben
Jun 21, 2020·Acta Physiologica·Dunbar Ivy
Sep 2, 2020·Current Heart Failure Reports·Barbro KjellströmEllen Ostenfeld
Jan 8, 2020·The International Journal of Cardiovascular Imaging·Michal SchäferMax B Mitchell
Jun 5, 2021·American Journal of Physiology. Heart and Circulatory Physiology·Michal SchäferMichael E Yeager
Apr 1, 2019·The Journal of Thoracic and Cardiovascular Surgery·Michal SchäferJames Jaggers
Dec 12, 2020·The Annals of Thoracic Surgery·Matthew L StoneMax B Mitchell

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