EurekaMag.com logo
+ Site Statistics
References:
47,893,527
Abstracts:
28,296,643
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on Google+Follow on Google+
Follow on LinkedInFollow on LinkedIn

+ Translate

Energy transfer ratio as a metric of right ventricular efficiency in repaired congenital heart disease


, : Energy transfer ratio as a metric of right ventricular efficiency in repaired congenital heart disease. Congenital Heart Disease 8(4): 328-342

With the success of early repair, continued functional assessment of repaired congenital heart disease is critical for improved long-term outcome. Pulmonary regurgitation, which is one of the main postoperative sequelae of congenital heart disease involved with the right ventricle (RV) such as tetralogy of Fallot and transposition of the great arteries, results in progressive RV dilatation coupled with pulmonary artery (PA) obstruction causing elevated RV pressures. The appropriate timing of intervention to correct these postoperative lesions remains largely subjective. In the present study, we evaluated an energy-based end point, namely energy transfer ratio (eMPA), to assess the degree of RV and PA inefficiency in a group of congenital heart disease patients with abnormal RV-PA physiology. Eight patients with abnormal RV-PA physiology and six controls with normal RV-PA physiology were investigated using a previously validated technique that couples cardiac magnetic resonance imaging and invasive pressure measurements. The mean eMPA of the patient group (0.56 0.33) was significantly lower (P <.04) than that of the control group (1.56 0.85), despite the fact that the patient group had a significantly higher RV stroke work indexed to body surface area (RV SWI) than the control group (0.205 0.095?J/m2 vs. 0.090 0.038?J/m2; P <.02). We determined that the patients had inefficient RV-PA physiology due to a combination of RV dilatation with pulmonary regurgitation and RV outflow obstruction leading to an elevated end-systolic pressure. Using coupled magnetic resonance imaging and invasive pressure measurements, eMPA is determined to be a sensitive energy-based end point for measuring RV-PA efficiency. It may serve as a diagnostic end point to optimize timing of intervention.


Accession: 036735779

PMID: 23331703

DOI: 10.1111/chd.12034

Submit PDF Full Text: Here


Submit PDF Full Text

No spam - Every submission is manually reviewed

Due to poor quality, we do not accept files from Researchgate

Submitted PDF Full Texts will always be free for everyone
(We only charge for PDFs that we need to acquire)

Select a PDF file:
Close
Close

Related references

Zeppenfeld, K., 2016: Ventricular tachycardia in repaired congenital heart disease. Ventricular arrhythmias are an important cause of late morbidity and sudden cardiac death in the growing population of adults with repaired congenital heart disease. Risk stratification remains challenging because of the heterogeneity of the malfo...

Stelling, J.A.; Danford, D.A.; Kugler, J.D.; Windle, J.R.; Cheatham, J.P.; Gumbiner, C.H.; Latson, L.A.; Hofschire, P.J., 1990: Late potentials and inducible ventricular tachycardia in surgically repaired congenital heart disease. We compared signal-averaged electrcardiography with invasive electrophysiological study in patients after surgical repair of congenital heart disease to determine if potentially useful correlations exist between the two methods for assessment of r...

Kapel, G.F.L.; Reichlin, T.; Wijnmaalen, A.P.; Piers, S.R.D.; Holman, E.R.; Tedrow, U.B.; Schalij, M.J.; Stevenson, W.G.; Zeppenfeld, K., 2015: Re-entry using anatomically determined isthmuses: a curable ventricular tachycardia in repaired congenital heart disease. Ventricular tachycardia (VT) is an important cause of late morbidity and mortality in repaired congenital heart disease. The substrate often includes anatomic isthmuses that can be transected by radiofrequency catheter ablation similar to isthmus...

Brouwer, C.; Hazekamp, M.G.; Zeppenfeld, K., 2016: Anatomical Substrates and Ablation of Reentrant Atrial and Ventricular Tachycardias in Repaired Congenital Heart Disease. Advances in surgical repair techniques for various types of congenital heart disease have improved survival into adulthood over the past decades, thus exposing these patients to a high risk of atrial and ventricular arrhythmias later in life. Thes...

van Zyl, M.; Kapa, S.; Padmanabhan, D.; Chen, F.C.; Mulpuru, S.K.; Packer, D.L.; Munger, T.M.; Asirvatham, S.J.; McLeod, C.J., 2016: Mechanism and outcomes of catheter ablation for ventricular tachycardia in adults with repaired congenital heart disease. Repaired congenital heart disease (rCHD) is strongly associated with ventricular tachycardia (VT) as an important late cause of morbidity and mortality. Ventricular reentry most commonly includes anatomic isthmuses created during the repair proced...

Karpawich, P.P.; Singh, H.; Zelin, K., 2015: Optimizing paced ventricular function in patients with and without repaired congenital heart disease by contractility-guided lead implant. This study evaluates the concept of optimizing ventricular pacing in regard to functional cardiac response. Lead implant based on physiologic variables of contractility at various sites was performed in patients with and without congenital heart d...

Kutty, S.; Deatsman, S.L.; Russell, D.; Nugent, M.L.; Simpson, P.M.; Frommelt, P.C., 2008: Pulmonary valve replacement improves but does not normalize right ventricular mechanics in repaired congenital heart disease: a comparative assessment using velocity vector imaging. This study evaluated regional right ventricular (RV) mechanics before and after pulmonary valve replacement (PVR) by ultrasonic speckle tracking technology using velocity vector imaging (VVI). Fifty-eight patients who underwent PVR (May 1999 to Au...

Hong, W-Jing.; Yung, T-cheung.; Lun, K-shing.; Wong, S.Jessica.; Cheung, Y-fai., 2009: Impact of right ventricular pacing on three-dimensional global left ventricular dyssynchrony in children and young adults with congenital and acquired heart block associated with congenital heart disease. The aim of this study was to determine the effect of long-term right ventricular pacing on left ventricular (LV) mechanical dyssynchrony in children and young adults with congenital and acquired heart block. Eighteen patients aged 19 +/- 7 years w...

Kantor, P.F.; Redington, A.N., 2011: Pathophysiology and management of heart failure in repaired congenital heart disease. Up to 20% of all postoperative patients with repaired congenital heart disease later develop symptoms of heart failure, but slow disease progression makes patients difficult to study. The incidence is higher in the presence of lesions with a solit...

Clark, J.B.; Pauliks, L.B.; Myers, J.L.; Undar, A., 2013: Mechanical circulatory support for end-stage heart failure in repaired and palliated congenital heart disease. Approximately one in one hundred children is born with congenital heart disease. Most can be managed with corrective or palliative surgery but a small group will develop severe heart failure, leaving cardiac transplantation as the ultimate treatme...