Oct 26, 2018

RV adaptation to increased afterload in congenital heart disease and pulmonary hypertension

PloS One
Mieke M P DriessenFolkert J Meijboom

Abstract

The various conditions causing a chronic increase of RV pressure greatly differ in the occurrence of RV failure, and in clinical outcome. To get a better understanding of the differences in outcome, RV remodeling, longitudinal function, and transverse function are compared between patients with pulmonary stenosis (PS), those with a systemic RV and those with pulmonary hypertension (PH). This cross-sectional study prospectively enrolled subjects for cardiac magnetic resonance imaging (CMR), functional echocardiography and cardiopulmonary exercise testing. The study included: controls (n = 37), patients with PS (n = 15), systemic RV (n = 19) and PH (n = 20). Statistical analysis was performed using Analysis of Variance (ANOVA) with posthoc Bonferroni. PS patients had smaller RV volumes with higher RV ejection fraction (61.1±9.6%; p<0.05) compared to controls (53.8±4.8%). PH and systemic RV patients exhibited dilated RVs with lower RV ejection fraction (36.9±9.6% and 46.3±10.1%; p<0.01 versus controls). PH patients had lower RV stroke volume (p = 0.02), RV ejection fractions (p<0.01) and VO2 peak/kg% (p<0.001) compared to systemic RV patients. Mean apical transverse RV free wall motion was lower and RV free wall shortening (p<0.00...Continue Reading

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Citations

Mentioned in this Paper

Neuro-Oncological Ventral Antigen 2
CDP-diacylglycerol-serine O-phosphatidyltransferase Activity
Study
Left Ventricle Remodeling
Magnetic Resonance Imaging
Left Ventricular Structure
Log-Linear Models
Congenital Heart Disease
Congenital Disorders
Cardiopulmonary Exercise Test

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