Right ventricular stroke work correlates with outcomes in pediatric pulmonary arterial hypertension

Pulmonary Circulation
Weiguang YangJeffrey A Feinstein

Abstract

Pulmonary arterial hypertension (PAH) is characterized by elevated pulmonary artery pressures (PAP) and pulmonary vascular resistance (PVR). Optimizing treatment strategies and timing for transplant remains challenging. Thus, a quantitative measure to predict disease progression would be greatly beneficial in treatment planning. We devised a novel method to assess right ventricular (RV) stroke work (RVSW) as a potential biomarker of the failing heart that correlates with clinical worsening. Pediatric patients with idiopathic PAH or PAH secondary to congenital heart disease who had serial, temporally matched cardiac catheterization and magnetic resonance imaging (MRI) data were included. RV and PA hemodynamics were numerically determined by using a lumped parameter (circuit analogy) model to create pressure-volume (P-V) loops. The model was tuned using optimization techniques to match MRI and catheterization derived RV volumes and pressures for each time point. RVSW was calculated from the corresponding P-V loop and indexed by ejection fraction and body surface area (RVSWEF) to compare across patients. Seventeen patients (8 boys; median age = 9.4 years; age range = 4.4-16.3 years) were enrolled. Nine were clinically stable; the ...Continue Reading

References

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Sep 10, 2013·Pulmonary Circulation·Shannon BlalockJeffrey Feinstein
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Feb 3, 2016·Chest·Rachel K HopperD Dunbar Ivy
May 6, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Stephanie L SiehrChandra Ramamoorthy
Apr 9, 2017·BMC Medical Research Methodology·Adina Najwa KamarudinRuwanthi Kolamunnage-Dona

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Citations

Jan 13, 2019·Biomechanics and Modeling in Mechanobiology·Weiguang YangJeffrey A Feinstein
Apr 28, 2020·Computer Methods in Applied Mechanics and Engineering·Casey M FleeterAlison L Marsden

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